孕期盆底肌锻炼联合导乐陪伴分娩对产科质量的影响

Effect of pelvic floor muscle exercises combined with Doula on obstetric quality

目的探讨孕期盆底肌锻炼联合导乐陪伴分娩对分娩质量及母婴健康的影响。方法选取292例孕妇，97例于妊娠28周开始盆底肌功能锻炼至分娩前，分娩时实施导乐陪伴分娩服务模式（观察组）；99例常规产前检查，分娩时实施导乐陪伴分娩服务模式（对照1组）；96例按常规妊娠分娩处理（对照2组）。对比各组分娩前盆底肌张力，并记录产程时间和阴道分娩情况。结果观察组盆底肌张力强于对照1组和对照2组（P〈0．05），产程缩短，自然分娩率显著提高，剖宫产率、阴道助产率、胎儿窘迫率、新生儿窒息率、产后出血率均明显降低，差异有显著性（P〈0．05）。结论孕期行盆底肌锻炼联合产时实施导乐陪伴分娩服务模式，可增强盆底肌张力、抑制不良情绪、缩短产程、提高自然分娩率、降低难产率、新生儿窒息率及产后出血率，提高产时质量，保障母婴健康。

Objective To explore the effects of pelvic floor muscle exercises combined with Doula on labor quality and maternal and child health. Methods 292 pregnant women were included in this study. 97 of the women began muscle function exercise at a gestational age of 28 weeks until childbirth and received Doula service during labor （ study group ） 99 women received conventional prenatal examination and Doula service during labor （ control group 1） and another 96 women received tradional delivery care （ control group 2 ）. Pelvic muscle tension was compared among the three groups. Duration of labor courses and vaginal delivery status were recorded. Results Muscle tension was stronger in the study group than in the control groups 1 and 2 （ P〈 0.05 ）. Duration of labor courses was shorter, rate of vaginal delivery markedly increased, and rates of C-section, assisted vaginal delivery, fetal distress and suffocation, and postpartum hemorrhage were lower in the study group, with a significant difference. Conclusions Prenatal pelvic floor muscle exercises combined with Doula during delivery can strengthen pelvic muscle tension, restrain adverse mood, shorten labor courses, enhance rate of vaginal delivery, reduce rates of dystocia, newborn suffocation, and postpartum hemorrhage, improve quality of childbirth, and guarantee maternal and child health.