摘要
目的观察评价孕产妇采取自由体位分娩与传统平卧位分娩对母婴分娩结局的影响效果。方法选择2011年6月至2016年5月期间本院收治的经阴道分娩的第一胎、单胎头位、足月妊娠、初产妇分娩1994例，按照数字表法随机分为两组；对照组997例采用传统的平卧位给予接产分娩；观察组997例采取产妇自主用力，取自由体位分娩、自然娩肩，比较两组的分娩结局、母婴情况及产妇的满意程度。结果两组产妇第一产程差异无统计学意义（P〉0．05），观察组产妇第二产程时间显著短于对照组（P〈0．05），观察组产妇产后2h出血量明显少于对照组（P〈0．05），观察组产妇会阴完整和I°裂伤冠著高于对照组（P〈0．05），而会阴侧切则明显少于对照组（P〈0．05），观察组肩难产发生率、新生儿产伤率、新生儿压迫性青紫发生率与对照组比较差异均无统计学意义（均P〉0．05），而观察组新生儿窒息及NICU入室率明显低于对照组（均P〈0．05），观察组产妇总满意度为96．99％，显著地高于对照组的83．85％（P〈0．05）。结论产妇第二产程自主用力，运用舒适自由体位分娩，大大地提高了产妇舒适度，有效地降低第二产程的时间及产后2h出血量；避免了会阴侧切、I°裂伤程度；降低了肩难产及新生儿产伤发生率，提倡产妇在第二产程中自主用力，运用适合产妇自己的自由体位分娩，等待自然娩肩。
Objective To observe the effects of free position delivery and traditional supine position delivery on maternal and child delivery outcomes. Methods 1 994 term primiparae with first fetus and single fetal head admitted into our hospital from January, 2011 to May, 2016 were selected and were randomly divided into a control group and an observation group using digital table method, 997 for each group. The control group took traditional supine position delivery and the observation group took free position delivery and dropped the shoulders. The delivery outcome and the maternal and child satisfaction were compared between these two groups.Results There was no statistical difference in the first stage of labor between these two groups （P 〉 0.05）. The the second stage of labor was significantly shorter in the observation group than in the control group （P 〈 0.05）. The bleeding volume 2 h after delivery was significantly higher in the observation group than in the control group （P 〈 0.05）. More primiparae got perineum intima and I° laceration and fewer took perineum in the observation group than in the control group （P 〈 0.05）. There were no statistical differences in the incidences of shoulder dystocia, neonatal injury, and neonatal oppressive bruising between these two groups （all P 〉 0.05）. More neonates were admitted into NICU in the observation group than in the control group （P 〈 0.05）. The total satisfaction rate was 96.99% in the observation group and 83.85% in the control group （P 〈 0,05）. Conclusions Primiparae autonomicly taking effort at second stage of labor and taking comfortable free position delivery can greatly improve maternal comfort, effectively shorten second stage of labor and reduce bleeding volume 2 h after delivery, avoid perineal lateral incision and I° laceration, and decrease shoulder dystocia and neonatal birth rates.
作者
曾慧琳
叶湘云
李艳芳
Zeng Huilin Ye Xiangyun Li Yanfang(Department of Obstetrics and Gynecology, Huizhou First Maternal and Child Health Hospital, Huizhou 516000, China , Department of Obstetrics, First Hospital Guangzhou University of Traditional Chinese Medicine, Guangzhou 315000, China)
出处
《国际医药卫生导报》
2017年第13期2054-2057,共4页
International Medicine and Health Guidance News
关键词
孕产妇
分娩
自由体位分娩
母婴结局
Puerperae
Childbirth
Free positon delivery
Maternal and child outcomes
