自由体位分娩配合会阴无保护接生技术对分娩结局的影响
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摘要
目的探讨自由体位分娩方式配合会阴无保护接生技术对产妇分娩结局以及新生儿的影响。方法采用前瞻性研究的方法,选取2017年2月至2018年6月秦皇岛市妇幼保健院收治的160例产妇,按照随机数字表法,将其分为研究组与对照组,每组各80例。研究组产妇给予自由体位分娩方式且配合会阴无保护接生技术,对照组产妇给予传统助产方式。比较两组产妇的会阴裂伤程度、会阴侧切率、第二产程时间、产后2 h出血量、新生儿窒息、新生儿Apgar评分、并发症情况、剖宫产率以及自然分娩率。结果研究组产妇第二产程时间为(45. 71±15. 68) min,短于对照组的(67. 62±17. 12) min,差异具有统计学意义(P <0. 05);研究组产妇的会阴Ⅱ度裂伤率(2. 5%vs. 10. 0%)、会阴侧切率(23. 75%vs. 55. 0%)、新生儿窒息率(2. 5%vs. 8. 75%)、剖宫产率(23. 75%vs. 46. 25%)及并发症发生率(3. 75%vs. 13. 75%)均显著低于对照组(P <0. 05);两组产后2 h出血量比较(151. 22±38. 46 ml vs. 147. 56±45. 89ml),差异无统计学意义(P> 0. 05);研究组新生儿Apgar评分(8. 02±0. 91分vs. 6. 99±1. 12分)、自然分娩率(76. 25%vs. 53. 75%)均高于对照组(P <0. 05)。结论自由体位分娩方式配合会阴无保护接生技术可有效降低剖宫产率,促进自然分娩,提高自然分娩率,减少会阴裂伤,能够最大程度地确保母婴安全。
Objective To explore free position combined with perineal unprotected delivery on maternal delivery outcome and newborn.Methods 160 pregnant women admitted to our hospital from February 2017 to June 2019 were selected prospectively and randomized into two groups. The study group( n = 80) underwent free position and unprotected delivering. The control group( n = 80) underwent traditional midwifery delivery. Comparison of maternal perineal laceration,episiotomy rate,second stage of labor duration,2 h postpartum hemorrhage amount,neonatal Apgar score,other complications,cesarean section rate and natural delivery rate. Results The second stage duration of study group was( 45. 71± 15. 68) min,which was shorter than control group's( 67. 62 ± 17. 12) min( P < 0. 05). The episiotomy rate,perineal laceration degree,neonatal asphyxia rate,cesarean section rate and complication rate of parturients in study group were significantly lower than in control group( P <0. 05). There was no significant difference in postpartum 2 h blood loss( P > 0. 05). The Apgar score and natural birth rate in study group were higher than in control group( P < 0. 05). Conclusion Free position delivery combined with unprotected delivery can effectively reduce cesarean delivery rate,promote natural delivery and result in less complications,which is in favor of mother and baby safety.
Objective To explore free position combined with perineal unprotected delivery on maternal delivery outcome and newborn.Methods 160 pregnant women admitted to our hospital from February 2017 to June 2019 were selected prospectively and randomized into two groups. The study group( n = 80) underwent free position and unprotected delivering. The control group( n = 80) underwent traditional midwifery delivery. Comparison of maternal perineal laceration,episiotomy rate,second stage of labor duration,2 h postpartum hemorrhage amount,neonatal Apgar score,other complications,cesarean section rate and natural delivery rate. Results The second stage duration of study group was( 45. 71± 15. 68) min,which was shorter than control group's( 67. 62 ± 17. 12) min( P < 0. 05). The episiotomy rate,perineal laceration degree,neonatal asphyxia rate,cesarean section rate and complication rate of parturients in study group were significantly lower than in control group( P <0. 05). There was no significant difference in postpartum 2 h blood loss( P > 0. 05). The Apgar score and natural birth rate in study group were higher than in control group( P < 0. 05). Conclusion Free position delivery combined with unprotected delivery can effectively reduce cesarean delivery rate,promote natural delivery and result in less complications,which is in favor of mother and baby safety.
引文
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[13]牛凤.自由体位配合无保护接生法在初产妇限制性会阴切开中的应用[J].泰山医学院学报,2017,38(01):73-74.
[14]于晶晶.自由体位配合无保护接生法在初产妇限制性会阴切开中的临床应用[J].实用临床护理学杂志,2017,2(40):109-113.
[15]温改红.两种不同接产方式在促进自然分娩中的效果分析[J].湖北科技学院学报(医学版),2018,32(2):149-151.
[16]苏浪,杨迎春.无保护会阴接生配合自由体位管理在初产妇自然分娩中的应用[J].当代护士,2016,12:53-54.
[2]李萍.会阴无保护接生效果观察[J].吉林医学,2015,(1):330-331.
[3]刘玉娥.无保护接生技术对母婴结局的影响及医疗资源利用的效果评价[J].中国实用护理杂志,2014,1(30):27-29.
[4]张惠欣,郝荣,张宏玉,等.第二产程分娩体位对分娩结局的影响[J].中华围产医学杂志,2014,17(11)743-744.
[5]苏浪,李建军.无保护会阴接生的临床观察与护理[J].当代护士(中旬刊),2014,(8):56-71.
[6]尹志芳,杨宗梅.两种不同体位纠正持续性枕后位对促进产妇自然分娩的效果分析[J].中国妇幼保健,2014,29(4):613.
[7]祁志宇,韩萍.自由体位分娩对促进自然分娩的临床研究[J].河北医药,2015,44(7):1000.
[8]陈美芳,黄海燕,张继红.半卧位屈大腿抱膝法与仰卧屈膝法分娩体位对产妇影响的对比研究[J].广西医学,2015,20(5):729-730.
[9]涂伟妹,刘佩蓉,郭爱英,等.初产妇在第二产程中采取自由体位联合无保护会阴接生对分娩效果的影响[J].实用临床医学,2014,15(8):68-69.
[10]沈卫英,楼建义,王春茶,等.会阴无保护接生技术在低危初产妇分娩中的应用[J].中国妇幼健康研究,2014,25(1):83-84.
[11]傅爱萍,周红,周临,等.无保护会阴助产技术促进自然分娩的效果观察[J].中华现代护理杂志,2014,20(28):3560.
[12]蒋荣英,刘三连,周坚霞.自由体位在促进疤痕子宫阴道分娩中的效果分析[J].临床和实验医学杂志,2017,16(10):984-986.
[13]牛凤.自由体位配合无保护接生法在初产妇限制性会阴切开中的应用[J].泰山医学院学报,2017,38(01):73-74.
[14]于晶晶.自由体位配合无保护接生法在初产妇限制性会阴切开中的临床应用[J].实用临床护理学杂志,2017,2(40):109-113.
[15]温改红.两种不同接产方式在促进自然分娩中的效果分析[J].湖北科技学院学报(医学版),2018,32(2):149-151.
[16]苏浪,杨迎春.无保护会阴接生配合自由体位管理在初产妇自然分娩中的应用[J].当代护士,2016,12:53-54.