水中分娩280例的临床研究

A clinical study on 280 cases of water birth

目的探讨水中分娩产妇的产程、分娩疼痛、产道裂伤、出血量以及新生儿结局,以评价水中分娩的效果及安全性。方法选取2007年5月至2008年5月280例水中分娩作为水中分娩组,选择相同条件、同期经阴道自然分娩配对孕妇280例作为对照组,分析水中分娩的产程减痛程度、失血量及会阴裂伤、新生儿窒息情况。结果与对照组比较,水中分娩组第一产程活跃期+第二产程缩短;水中分娩宫颈扩张速度为2.62±0.46cm/h(t=28.171,P<0.05),水中分娩组产妇入水后疼痛分级较入水前明显降低(χ2=28.372,P<0.05);水中分娩组会阴侧切率较对照组明显降低(χ2=64.897,P<0.05)。两组新生儿的Apgar评分比较无显著性差异(χ2=2.581,P>0.05)。水中分娩组新生儿入新生儿重症监护室治疗率较对照组低(χ2=19.695,P<0.05)。结论水中分娩可减轻产妇的疼痛,缩短产程;对母亲、新生儿未见不良结局,是安全可行的。

Objective To investigate birth process, labor pain laceration of birth canal, and intrapartum hemorrhage of the parturients who delivered under water and outcome of the neonate, so as to evaluate effects of water birth on maternal and neonatal outcomes and its safety. Methods 280 pregnant women who delivered under water from May 2007 to May 2008 were enrolled in the water birth group and another 280 pregnant women who delivered vaginally in the same conditions and same time were as the control group. The birth process, birth pain, intrapartum hemorrhage, perineal tears of the parturients, and incidence of neonatal asphyxia were compared between the two groups. Results In water birth group, the total drnation of active phase of the first stage of labor and the second stage of labor was shorter than that in the control group,and velocity of cervical extension was 2.62 ±0.46 cm/h in water birth group（t =28. 171, P 〈0.05）. The grading of labor pain in the water birth group was significantly lowered after the parturient women got into water （χ^2 = 28. 372, P 〈 0.05 ）. The rate of lateral perineotomy in the water birth group was significantly lower than that in the control group （χ^2 = 64. 897, P 〈 0.05 ）. Apgar＇ s scores of the neonates in the two groups were similar （P 〉 0.05）. The rate of admission to NICU in the water birth group was lower than that in the control group （χ^2 = 19. 695, P 〈 0.05 ）. Conclusion Water birth can relieve labor pain and shorten the stage of labor. No maternal and neonatal adverse effects in water birth group are found. So water birth is safe and feasible.