第二产程不同分娩体位干预及阴道保护对初产妇分娩结局的影响

Effect of different delivery position and vaginal protection on the outcome of primipara delivery in the second stage of labor

目的探讨新产程标准下第二产程不同分娩体位干预及阴道保护对初产妇分娩结局的影响结果。方法选取我院产科2017年01月~2019年09月120例经阴道分娩初产妇,按照随机数字表分为对照组和观察组(每组60例)。对照组在第二产程采取传统仰卧位联合托肛保护会阴接产方式进行分娩,观察组在第二产程采取侧卧位联合无保护会阴接产方式进行分娩。对比两组产妇第二产程时长、总产程时间、会阴损伤情况、产后2 h出血量、分娩转剖宫产率、新生儿窒息发生率。结果观察组第二产程时长、总产程时间及产后2h出血量明显短于对照组(P<0.05);观察组会阴侧切率、裂伤程度、分娩转剖宫产率均明显低于对照组(P<0.05);对照组新生儿窒息发生率高于观察组(P<0.05)。结论新产程标准下,侧卧位联合无保护会阴接生较传统仰卧位联合托肛保护会阴接产效果更为理想。

Objective To investigate the effect of different delivery position and vaginal protection on the outcome of primipara delivery in the second stage of labor under the new labor standard.Methods A total of 120 vaginal delivery primiparas from January 2017 to September 2019 in our hospital were selected.The patients were divided into control group and observation group according to the random number table(60 cases in each group).In the second stage of labor,the control group was given a traditional supine position combined with an anus to protect the perineal delivery mode for delivery.The observation group used the lateral position in the second stage of labor combined with the unprotected perineum delivery method for delivery.The duration of the second stage of labor,total labor time,perineal injury,2h postpartum hemorrhage,delivery cesarean section rate,and neonatal asphyxia incidence were compared between the two groups.Results The duration of the second stage of labor,the total labor time and the postpartum 2h bleeding volume in the observation group were significantly shorter than those in the control group(P<0.05).The perineal rate,laceration,and delivery rate were significantly lower in the observation group than in the control group(P<0.05).<0.05);the incidence of neonatal asphyxia in the control group was higher than that in the observation group(P<0.05).Conclusion Under the new labor standard,the lateral position combined with unprotected perineal delivery is more ideal than the traditional supine position combined with anal protection for perineal delivery.