不同助产方式对初产妇妊娠结局的影响

目的观察不同助产方式对初产产妇妊娠结局的影响。方法纳入2015年10月至2016年10月收治的124例初产产妇（均拟行经阴道分娩）为观察对象，依据随机数表法分为观察组（分娩球与自由体位联合助产）与对照组（传统体位，平卧或侧卧分娩），每组各62例。比较两组妊娠结局及产程变化，并应用中文版简化McGin疼痛问卷，比较两组疼痛评分。结果观察组剖宫产率较对照组低，且顺产率较对照组高，差异有统计学意义（P〈0．05），而阴道助产率比较差异无统计学意义（P〉0．05）；观察组第一产程、第二产程、第三产程及总产程时间与产后2h出血量均低于对照组，差异有统计学意义（P〈0．05）；两组干预后VAS、PPI及PRI情感总分、PRI感觉总分、PRI总分均较干预前低，且干预后观察组上述各疼痛指标得分均较对照纽低，差异均有统计学意义（P〈0．05）。结论分娩球与自由体位联合助产能缓解初产产妇分娩疼痛，改善妊娠结局。

Objective To obverse the effect of different midwifery methods on the pregnancy outcome of primipara. Methods 124 cases of primipara puerpera were enrolled from October 2015 to October 2016 in our hospital （all underwent vaginal delivery ） as the object, and randomly divided into observation group （ delivery ball and free position joint Midwifery ） and control group （ traditional position, supine or side delivery ） 62 cases.The outcome of 2 groups of pregnancy and the change of birth process were compared, and the Chinese version of the simplified McGill pain questionnaire was adopted, and the pain scores of the 2 groups were compared. Results The cesarean section rate in the observation group was lower than that in the control group, and the rate of spontaneous delivery was higher than that in the control group. The difference was statisfcally significant （ P〈0.05 ） , while there was no significant difference in vaginal delivery rate （ P〉0.05 ） . The first stage of the observation group, the second stage of labor, third bleeding stroke and total duration and postpartum 2H were lower than the control group, the difference was statistically significant （ P〈0.05 ） . After intervention, the total score of VAS, PPI and PILl, PILl total score and total score of PRI in two groups were lower than those before intervention. The scores of pain indicators in the observation group were lower than those in the control group after intervention, and the differences were statistically significant （ P〈0.05 ） . Conclusion The combination of delivery ball and free posture helps to relieve the pain of childbirth in primipara and improves the pregnancy outcome.