助产士门诊对孕期体质量管理影响的分析

Effect of midwives′antenatal clinic service on management of gestational weight gain

目的探讨助产士门诊对孕妇孕期体质量管理及分娩结局的影响。方法选择在该院建卡并定期产检的初产妇,按就诊时间先后顺序分为观察组(208例)和对照组(212例)。观察组除接受医生门诊外,还接受助产士门诊;对照组接受常规产前门诊。比较两组的孕期体质量增长、分娩结局等。结果观察组孕期体质量增长超质量率低于对照组,差异有统计学意义(P<0.01);观察组顺产率高于对照组,其巨大儿发生率、会阴侧切率、分娩镇痛率均低于对照组,差异有统计学意义(P<0.01);两组新生儿体质量分别为(3 250.58±270.03)g、(3 405.42±403.28)g,差异有统计学意义(t=28.610,P<0.01);两组产后2h出血量分别为(199.13±64.37)mL、(249.53±93.56)mL,差异有统计学意义(t=20.581,P<0.01);两组孕妇妊娠期糖尿病发生率、妊娠期高血压发生率和胎儿宫内窘迫发生率的差异无统计学意义(P>0.05)。结论助产士门诊可有效管理孕妇孕期体质量,改善分娩结局,提供孕妇分娩正性体验。

Objective To evaluate the effect of midwives′antenatal clinic service on management of gestational weight and birth outcomes.Methods Totally 420 primiparas who had made registration and regular antenatal examination in a hospital,were randomly divided into two groups.The women in the control group（n=208）received routine antenatal clinicservice.In addition,the women in the experimental group（n=212）participated in an individual midwives′antenatal clinic.The primiparas′gestational weight gain and birth outcomes were measured and compared between the two groups.Results The rate of natural birth in the experimental group was higher than that of the control group.The rate of fetal macrosomia,episiotomy and labor analgesia were lower than that of the control group（P〈0.01）.The rate of naturalbirth,fetal macrosomia,episiotomy,labor analgesia were significantly lower than that of the control group（P〈0.01）.The neonatal weight[（3 250.58±270.03）g vs.（3 405.42±403.28）g]and volume of bleeding[（199.13±64.37）mL vs.（249.53±93.56）mL]2hours postpartum in the experimental group were significantly lower than that of the control group（t=28.610,P〈0.01;t=20.581,P〈0.01）.There were no significant differences in the rate of gestational diabetes mellitus,pregnancy-induced hypertension and fetal distress in uterusbetween the two groups（P〈0.05）.ConclusionThe midwives′antenatal clinic service has good effects on management ofgestational weight gain,improves birth outcomes and provides primiparas positive experience of childbirth.