无痛导乐仪、导乐陪伴分娩、孕产妇体位改变联合应用对分娩方式的影响

Impact of the Combination Use of Painless Doula Instrument,Doula Delivery,Maternal Posture Change on the Delivery Mode

目的探讨无痛导乐仪、导乐陪伴分娩、产妇体位改变联合应用对分娩方式的影响。方法选择孕产妇宫口2～3 cm时,经阴道检查、肛查或B超检查为枕后位或枕横位的孕产妇367例,行无痛导乐仪、导乐陪伴分娩、产时体位改变模式的为试验组;同期选择相同条件的孕产妇分娩的268例,取自由体位与传统模式助产的为对照组。对两组经阴道分娩率、剖宫产率、难产率、产时产后出血率、新生儿窒息率进行比较。结果试验组经阴道分娩率为77.11%,对照组经阴道分娩率为50.00%,试验组比对照组阴道分娩率升高,差异有统计学意义(P<0.05)。试验组剖宫产及难产率分别为9.26%、0.02%,与对照组比较,差异有统计学意义。试验组新生儿窒息率为2.45%,与对照组的5.22%相比,显著低于对照组(P<0.05)。试验组比对照组经阴道分娩率显著升高(P<0.05),剖宫产及难产率下降,产时、产后出血率和新生儿窒息率显著低于对照组(P<0.05)。结论无痛导乐仪、导乐陪伴分娩、产时体位改变联合应用能提高顺产率,新生儿窒息率下降,值得在临床上推广应用。

Objective To explore the impact of the combination use of painless doula instrument,doula delivery,maternal posture change on the delivery mode.Methods 367 cases of pregnant women with 2-3 cm cervix,of occiput posterior or transverse position by vaginal examination,inspection or B ultrasound examination,were given painless guide instrument,doula,body position changes during delivery,were chosen as the trial group;268 cases of the same condition taking the free position and the traditional model of midwifery were selected as a control group.Vaginal delivery rate,cesarean section rate,dystocia rate,intrapartum and postpartum hemorrhage,and neonatal asphyxia of the two groups were compared.Results Vaginal delivery rate of the trial group was 77.11%,of the control group was 50.00%,the difference between the two groups was statistically significant（P0.05）,cesarean section and dystocia rate of the trial group was 9.26% and 0.02% respectively with a statistically significant difference to the control group.Neonatal asphyxia rate（2.45%）of the trial group were significantly lower than that of the control group（5.22%）（P0.05）.Intrapartum and postpartum hemorrhage of the trial group was significantly lower than that of the control group as well（P0.05）.Conclusion Combined application of doula painless instrument,doula delivery,body position changes during delivery can improve the eutocia rate and lower the neonatal asphyxia rate,thus is worthy of clinical application.