孕足月乳房按摩促进宫颈成熟及分娩的效果观察短篇论著

Full-term-breast massage to promote cervical ripening and parturition results

目的探讨孕足月乳房按摩对促进宫颈成熟及分娩的有效性和安全性。方法采用前瞻、对照研究的方法,将100例初产、单活胎、头位、无妊娠合并症及并发症、无明显阴道分娩禁忌的孕妇分为两组,两组孕38+5周确定胎儿成熟后首次记录宫颈评分,研究组50例孕妇在专人指导下进行双侧乳房按摩(手持温湿布交替按摩双侧乳房,每天3次,每次1 h);对照组50例常规产检组。观察两组至临产后宫颈成熟情况、临产的孕周,分娩方式、产程时间和新生儿情况。结果研究组宫颈Bishop评分增加总有效率为100%,临产时宫颈Bishop评分(8.9±3.8)分,延期妊娠1例,剖宫产率为18%,平均产程为(7.92±4.10)h,新生轻度窒息1例;对照组宫颈Bishop评分增加总有效为76%,临产时宫颈Bishop评分(5.5±2.87),延期妊娠7例,过期妊娠2例,剖宫产率36%,平均产程为(12.28±4.18)h,新生儿轻度窒息2例,重度窒息1例,两组比较,差异有显著性(P<0.01)。结论孕足月乳房按摩对促进宫颈自然成熟,促进阴道分娩,更加简便、安全、有效,同时能有效降低因延期妊娠、过期妊娠造成的剖宫产率,对适时分娩有一定的临床应用价值。

[ Objective ] To evaluate the effectiveness and safety of the breast stimulation expediting the cervical ripening and labour. [ Methods ] 100 primiparas with single viable fetus in longitudinal lie with head, without complicating disease and contraindication of vaginal delivery were scored in 38±5 weeks, and separated into the study group with breast stimulation and control group with regular tests except for the breast stimulation. [ Resluts ] For the study group and control group, the cervical Bishop score was 100% and 76% increased, the Bishop score before delivery was （8.9 ± 3.8） and （5.5 ± 2.87）. There were one and two cases with prolonged pregnancy respectively. The rate of uterine-incision delivery were 18% and 36%. And average time of labor was （7.92 ± 4.10） h and （12.28 ± 4.18） h. There were one case and two cases with the mild asphyxia neonatorum in each group, and one case in control group with sever asphyxia neonatorum. The data indicated the significant different between two groups （P〈0.01）. [ Conclusions ] The advance of the labour process by breast stimulation safe and effective. And this method could remarkably decrease the chance of uterine-incision delivery caused by the prolonged or delayed pregnancy, which should be utilized in routine clinical work.