自由舒适体位待产对胎膜早破孕妇阴道分娩率、Bishop宫颈评分及分娩产程时间等影响

Effect of free and comfortable posture on vaginal delivery rate,Bishop cervical score and delivery time of pregnant women with premature rupture of membranes

目的:探讨和分析自由舒适体位待产对胎膜早破孕妇阴道分娩率、Bishop宫颈评分及分娩产程时间等影响。方法:以我院2016年12月~2018年12月期间住院待产的胎膜早破孕妇168例为研究对象,将其随机分为研究组与对照组,每组各位84例。研究组孕产妇入院后自由选择舒适体位,对照组则采用常规卧床休息,待宫口全开后均上产床。观察两组最终分娩方式、第一和第二产程时间、产后出血量、产前羊水量,进行Bishop宫颈评分,记录新生儿出现窘迫及产妇不良事件结果。结果:研究组实施阴道分娩75例,剖宫产9例,对照组阴道分娩64例,剖宫产20例。两组最终选择分娩方式上具有统计学意义;两组第一产程、第二产程、产前羊水流出量指标经比较具有明显统计学意义,产后出血量方面无统计学意义;研究组Bishop宫颈评分总分高于对照组;产后经Apgar评分,两组具有统计学意义;研究组经阴道分娩产妇不良事件发生率(17.74%)明显低于对照组(47.50%)。结论:产科中对于足月胎膜早破孕妇,在严密监测胎心及综合孕妇自身素质条件下,选择自由体位待产满意度较传统体位高,产程及产前羊水流出量明显减少,且降低了经阴道分娩后新生儿及产妇的不良事件发生率,可在产科中后期进一步推广实施。

Objective To explore and analyze the effects of free and comfortable posture on vaginal delivery rate,Bishop cervical score and delivery time of pregnant women with premature rupture of membranes.Methods 168 pregnant women with premature rupture of membranes who were hospitalized in our hospital from December 2016 to December 2018 were randomly divided into study group and control group with 84 cases in each group.The pregnant and lying-in women in the study group were free to choose comfortable posture after admission,while those in the control group were given routine bed rest,and all of them went to bed after the opening of the uterine orifice.The final delivery mode,the first and second stages of labor,the amount of postpartum hemorrhage and the amount of amniotic fluid before delivery were observed.Bishop cervical score was used to record the results of neonatal distress and maternal adverse events.Results There were 75 cases of vaginal delivery,9 cases of cesarean section in the study group,64 cases of vaginal delivery in the control group and 20 cases of cesarean section in the study group.There was significant difference in the final choice of delivery mode between the two groups;the first stage of labor,the second stage of labor,the prenatal amniotic fluid outflow index between the two groups had significant statistical significance,and the postpartum hemorrhage volume had no statistical significance;the Bishop cervical score of the study group was higher than that of the control group;the postpartum Apgar score of the two groups had statistical significance.The incidence of adverse events in the study group(17.74%)was significantly lower than that in the control group(47.50%).Conclusion For full-term premature rupture of membranes pregnant women in obstetrics,under the condition of closely monitoring fetal heart rate and comprehensive pregnant women's own quality,the satisfaction of choosing free posture for delivery is higher than that of traditional posture,and the outflow of amniotic fluid during labor and prenatal period is significantly reduced,and the incidence of adverse events of newborns and pregnant women after vaginal delivery is reduced,which can be further promoted in the mid and late stages of obstetrics.