连续性助产服务对初产妇分娩结局的影响

Effect of continuous midwifery services on primipara delivery outcome

目的：探讨连续性助产服务对初产妇分娩结局的影响。方法选取2012年10月至2013年9月在我院产科门诊建卡并定期产检的正常低危初产妇420例，随机分为观察组和对照组各210例。对照组在产科门诊医生处接受常规产科检查，根据分娩计划提供相应护理。观察组在本院产科门诊建卡后，经产科门诊医生转介到助产士门诊进行连续性助产服务。观察两组孕妇的心理适应状况、分娩结局（自然分娩率、新生儿窒息率）、满意度以及助产士职业价值观。结果观察组自然分娩率、选择非药物镇痛方法、对助产士服务及围产期经历满意度明显高于对照组，其焦虑状态明显低于对照组，差异有统计学意义（P〈0.01），开展连续性助产服务后，助产士的职业价值观有明显提高（P〈0.01），两组在新生儿窒息率方面无明显差异（P〉0.05）。结论实施连续性助产服务可有效减轻初产妇焦虑程度，提高其自然分娩信心，促进自然分娩，提高孕产妇满意度，同时体现了助产士的专业核心才能。

Objective To investigate the effect of continuity of midwifery services on primipara delivery out-come. Methods 420 cases of normal low risk pregnant women who checked in the maternity clinic in our hospital regu-larly, were randomly divided into observation group and control group, during October 2012 -September 2013 . Cases in the control group received routine obstetric examination, according to the delivery plan, provided the corresponding nursing. Cases in the observation group were referred to the midwife clinic for continuity of midwifery services. Anxiety scores, delivery outcome （ the natural birth rate, neonatal asphyxia rate） , satisfaction and the value view of midwives were compared. Results The index of the natural birth rate, choice of non pharmacological analgesic methods, service satisfaction in the observation group were significantly better than those of the control group, the differences were signifi-cant （ P〈0. 01 ） . The occupation value outlook of midwives was significantly improved. There was no significant differ-ence between the two groups in asphyxia of neonates （ P〉0. 05 ） . Conclusions The implementation of continuity of midwifery services can effectively reduce maternal anxiety, promoting natural delivery, improve the service satisfaction and reflect the professional core ability of midwives.