自由体位对活跃期初产妇分娩结局的影响

Impact of freedom postures on active at the stages of labor of maternity outcomes

目的探讨实施自由体位对活跃期初产妇分娩结局的影响。方法选取220例拟行经阴道分娩的初产妇,随机分为干预组和对照组各110例,对照组活跃期采用常规平躺体位,干预组活跃期采用自由体位管理,观察两组活跃期胎先露下降速度,第一、第二、第三及总产程时间,最终采用的分娩方式,新生儿体重、新生儿Apgar评分、产后24 h出血量、产妇及新生儿并发症。结果干预组胎先露下降速度明显较对照组快(P<0.05),第一、第二产程及总产程较对照组均明显缩短(P<0.05)。干预组阴道分娩率明显较对照组高(P<0.05),阴道助产、剖宫产率明显较对照组低(P<0.05),两组新生儿体重、新生儿Apgar评分比较,差异无统计学意义(P>0.05),干预组产后24 h出血量明显较对照组少(P<0.05)。干预组产后出血、尿潴留、新生儿窒息率均明显较对照组低(P<0.05)。结论分娩活跃期实施自由体位更有助于胎先露下降缩短产程,提高阴道分娩率,降低产妇及新生儿并发症发生率。

Objective To investigate the impact of the implementation of free-position active at the stages of labor maternity outcomes. Methods The proposed transvaginal delivery primipara 220 cases were randomly divided into intervention group and control group,each of 110 patients, the control group used conventional supine position of the active, intervention group treated with a free-position active management, the rate of first exposed decline, the first, second and third of the total labor time and, finally adopted the mode of delivery, birth weight, Apgar score, 24h postpartum hemorrhage, maternal and neonatal complications of fetal activity were observed. Results The intervention group decreased fetal speed were significantly faster than the control group （P〈0.05）, the first and second stage of labor and total labor were significantly shorter than the control group （P〈0.05）. In the intervention group, vaginal delivery rate was significantly higher than the control group （P〈0.05）, vaginal delivery, cesarean section rate were significantly lower than the control group（P〈0.05）, birth weight, Apgar score between two groups, the difference were not statistically significance （p〉0.05）. In the intervention group, 24 h postpartum hemorrhage were significantly less than the control group （P〈0.05）, hemorrhage, urinary retention, neonatal asphyxia were significantly lower than the control group （P〈0.05）. Conclusion The implementation of active labor freedom fetal position can help decrease shorten the production process, improve the rate of vaginal delivery, reduce maternal and neonatal morbidity .