产科凝胶在降低初产妇会阴侧切率中的效果观察
|
摘要
目的确定产科凝胶是否对初产妇的会阴发挥保护作用,并且降低侧切发生率。方法选取2016年3至6月于首都医科大学附属北京天坛医院产科自然分娩的初产妇227例,自愿参与无菌产科凝胶实验研究产妇105例,设为观察组,于宫口开大2cm至新生儿娩出期间,每次阴道检查时将无菌产科凝胶应用于产道。未使用无菌产科凝胶的产妇122例为对照组。比较两组侧切率及新生儿生后Apgar评分。结果观察组会阴侧切率较对照组低18.81%,差异有统计学意义(χ~2=10.11,P=0.00)。新生儿生后Apgar评分1分钟、5分钟、10分钟无统计学显著差异(t值分别为1.70、0.89、0.83,均P>0.05)。结论通过在产程中系统的使用无菌产科凝胶,可润滑产道,增加会阴部组织延展性,有利于胎头下降及对于会阴保护,显著降低会阴侧切率,且对新生儿无显著不良影响。
Objective To determine the effects of obstetric gel on perineum protection of primipara and on reducing the incidence of lateral episiotomy.Methods Totally 227 cases of primipara with natural childbirth in Beijing Tiantan Hospital during March to June in 2016 were included in our research.There were 105 cases willing to use sterile gel and they were set as observation group.When the cervix opened 2 cm,the sterile gel was applied to obstetric tract during each vaginal examination.Control group included 122 cases who did not use sterile obstetric gel.Two groups were compared in rate of lateral episiotomy and Apgar score after birth.Results Compared with the control group,the episiotomy rate of the observation group reduced by 18.81%,and the difference was statistically significant(χ~2=10.11,P=0.00).There was no significant difference in Apgar score of 1 minute,5 minutes and 10 minutes after birth(t=1.70,P=0.08;t=0.89,P=0.48;t=0.83,P=0.46).Conclusion With using sterile obstetric gel in labor,the extensibility of perineal tissue increases significantly,that is helpful for descending of fetal head and reducing the rate of episiotomy remarkably without adverse effects on newborns.
Objective To determine the effects of obstetric gel on perineum protection of primipara and on reducing the incidence of lateral episiotomy.Methods Totally 227 cases of primipara with natural childbirth in Beijing Tiantan Hospital during March to June in 2016 were included in our research.There were 105 cases willing to use sterile gel and they were set as observation group.When the cervix opened 2 cm,the sterile gel was applied to obstetric tract during each vaginal examination.Control group included 122 cases who did not use sterile obstetric gel.Two groups were compared in rate of lateral episiotomy and Apgar score after birth.Results Compared with the control group,the episiotomy rate of the observation group reduced by 18.81%,and the difference was statistically significant(χ~2=10.11,P=0.00).There was no significant difference in Apgar score of 1 minute,5 minutes and 10 minutes after birth(t=1.70,P=0.08;t=0.89,P=0.48;t=0.83,P=0.46).Conclusion With using sterile obstetric gel in labor,the extensibility of perineal tissue increases significantly,that is helpful for descending of fetal head and reducing the rate of episiotomy remarkably without adverse effects on newborns.
引文
[1]陈思,叶宇齐,王静,等.经阴道分娩结局与会阴侧切的临床分析[J].中国计划生育和妇产科,2016,8(3):17-19.
[2]Sagi-Dain L,Bahous R,Caspin O,et al.No episiotomy versus selective lateral/mediolateral episiotomy(EPITRIAL):an interim analysis[J].Int Urogynecol J,2018,29(3):415-423.
[3]Rodriguez M I,Seuc A,Say L,et al.Episiotomy and obstetric outcomes among women living with type 3female genital mutilation:a secondary analysis[J].Reprod Health,2016,13(1):131.
[4]叶兆兰,张轶兰,彭继蓉.改良助产方式对降低阴道分娩会阴侧切率的效果观察[J].中国妇幼健康研究,2016,27(9):1131-1133.
[5]李华,凌艳姣.分娩会阴侧切和自然裂伤与盆底功能的相关性[J].中国妇幼健康研究,2015,26(1):78-80.
[6]Seval M M,Yüce T,Yak1st1ran B,et al.Effects of obstetric gel on the process and duration of labour in pregnant women:randomised controlled trial[J].J Obstet Gynaecol,2017,37(6):714-718.
[7]Muhleman M A,Aly I,Walters A,et al.To cut or not to cut,that is the question:a review of the anatomy,the technique,risks,and benefits of an episiotomy[J].Clin Anat,2017,30(3):362-372.
[8]Suto M,Takehara K,Misago C,et al.Prevalence of perineal lacerations in women giving birth at midwife-led birth centers in Japan:a retrospective descriptive study[J].J Midwifery Womens Health,2015,60(4):419-427.
[2]Sagi-Dain L,Bahous R,Caspin O,et al.No episiotomy versus selective lateral/mediolateral episiotomy(EPITRIAL):an interim analysis[J].Int Urogynecol J,2018,29(3):415-423.
[3]Rodriguez M I,Seuc A,Say L,et al.Episiotomy and obstetric outcomes among women living with type 3female genital mutilation:a secondary analysis[J].Reprod Health,2016,13(1):131.
[4]叶兆兰,张轶兰,彭继蓉.改良助产方式对降低阴道分娩会阴侧切率的效果观察[J].中国妇幼健康研究,2016,27(9):1131-1133.
[5]李华,凌艳姣.分娩会阴侧切和自然裂伤与盆底功能的相关性[J].中国妇幼健康研究,2015,26(1):78-80.
[6]Seval M M,Yüce T,Yak1st1ran B,et al.Effects of obstetric gel on the process and duration of labour in pregnant women:randomised controlled trial[J].J Obstet Gynaecol,2017,37(6):714-718.
[7]Muhleman M A,Aly I,Walters A,et al.To cut or not to cut,that is the question:a review of the anatomy,the technique,risks,and benefits of an episiotomy[J].Clin Anat,2017,30(3):362-372.
[8]Suto M,Takehara K,Misago C,et al.Prevalence of perineal lacerations in women giving birth at midwife-led birth centers in Japan:a retrospective descriptive study[J].J Midwifery Womens Health,2015,60(4):419-427.