摘要
目的:分析产时超声监测胎心及胎方位结合新产程时限管理后高龄产妇的产程与妊娠结局。方法:回顾性选取2020年10月—2022年12月上饶市妇幼保健院高龄产妇60例,依据产时监测方法不同分组为对照组(予以胎心电子监护仪监测结合Friedman产程管理,n=30)、观察组(予以彩色多普勒超声监测结合新产程时限管理,n=30),比较两组的各产程时间、各产程时疼痛度、母婴结局、产后6周盆底功能。结果:观察组经阴道自然分娩率为73.33%,高于对照组的46.67%,而剖宫产率为26.67%,低于对照组的53.33%(P<0.05),观察组产后出血率低于对照组(P<0.05),两组会阴撕裂、产时发热、胎儿宫内窘迫,以及新生儿窒息、新生儿低体重、新生儿入住重症监护室发生率差异均无统计学意义(P>0.05);观察组产妇第一产程、第二产程、总产程时间均较对照组长(P<0.05);观察组第一产程、第二产程、第三产程中疼痛视觉模拟评分法(VAS)评分均低于对照组(P<0.05);产后6周,观察组盆底肌活力值、功值及峰值均大于对照组(P<0.05)。结论:产时超声监测胎心、胎方位结合新产程时限管理应用于高龄产妇中可促使产程延长,引导产妇经阴道分娩,减少剖宫产风险,改善母婴结局,促进盆底肌功能恢复。
Objective:To analyze the labor process and pregnancy outcomes of elderly women after intrapartum ultrasound monitoring fetal heart rate and fetal position combined with new labor duration management.Method:A total of 60 elderly women admitted to Shangrao Maternal and Child Health Care Hospital from October 2020 to December 2022 were reviewed.They were assigned to the control group(monitoring with a electronic fetal heart rate monitor combined with Friedman labor process management,n=30)and the observation group(monitoring with color Doppler ultrasound combined with new labor duration management,n=30)according to different intrapartum monitoring methods.The duration of each stage of labor,pain degree in each stage of labor,maternal and neonatal outcomes and pelvic floor function at 6 weeks after delivery were compared between the two groups.Result:The natural delivery rate in the observation group(73.33%)was higher than that in the control group(46.67%),and the cesarean section rate(26.67%)was lower than that in the control group(53.33%),the differences were significant(P<0.05).The incidence of postpartum hemorrhage in the observation group was lower than that in the control group(P<0.05).The incidence rates of laceration of perineum,intrapartum fever,intrauterine fetal distress,neonatal asphyxia,low birth weight and admission to intensive care unit in the two groups were no significant differences(P>0.05).The first stage of labor,second stage of labor and total stage of labor in the observation group were longer than those in the control group(P<0.05).The visual analogue scale(VAS)scores of the observation group in the first,second and third stages of labor were lower than those of the control group(P<0.05).At 6 weeks after delivery,the activity value,work value and peak value of pelvic floor muscles in the observation group were higher than those in the control group(P<0.05).Conclusion:Intrapartum ultrasound monitoring fetal heart rate and fetal position combined with new labor duration management can prolong the labor process,promote natural delivery,reduce the risk of cesarean section,improve maternal and neonatal outcomes,and promote the recovery of pelvic floor muscle function in elderly women.
作者
李萍梅
吴知蔓
姚灵梅
LI Pingmei;WU Zhiman;YAO Lingmei(Shangrao Maternal and Child Health Care Hospital,Jiangxi Province,Shangrao 334000,China;不详)
出处
《中国医学创新》
CAS
2023年第21期147-152,共6页
Medical Innovation of China
基金
上饶市指导性科技计划项目(2022CZDX33)。
关键词
产时超声
胎心
胎方位
新产程时限管理
高龄产妇
产程
妊娠结局
Intrapartum ultrasound
Fetal heart rate
Fetal position
New labor duration management
Elderly puerpera
Labor process
Pregnancy outcome
