150例自由体位分娩与自然分娩的关系研究及产后护理管理

Relationship between Free labor and Natural Position of 150 Cases of Childbirth and Post-natal Care Management

目的探讨自由体位分娩与自然分娩的关系以及产后护理管理。方法选取该院在2014年10月—2015年8月期间收治的150例住院分娩的孕妇,按照分娩方式将患者分为2组,对照组与观察组,每组75例,对照组孕妇分娩时采用传统平卧位分娩,观察组孕妇采用自由体位分娩,可以选择蹲位、坐位、俯卧位、侧卧位和直立位,分析自由体位分娩与自然分娩的关系,结合胎位情况以及胎儿体重评价传统体位与自由体位分别对母婴结局的影响,并评价其分娩满意度。结果观察组剖宫产率1.33%(1/75)、阴道助产率2.67%(2/75)、会阴侧切率6.67%(5/75)、会阴严重裂伤率4.0%(3/75)、肩难产发生率5.33%(4/75),对照组剖宫产率10.67%(8/75)、阴道助产率16.0%(12/75)、会阴侧切率20.00%(15/75)、会阴严重裂伤率10.67%(8/75)、肩难产发生率12.00%(9/75);观察组剖宫产率、阴道助产率、会阴侧切率、会阴严重裂伤率、肩难产发生率均明显低于对照组,差异有统计学意义(P<0.05);观察组的产程时间明显短于对照组,差异有统计学意义(P<0.05),观察组产妇分娩时疼痛程度明显低于对照组,差异有统计学意义(P<0.05);观察组产妇分娩时舒适满意度明显高于对照组,差异有统计学意义(P<0.05)。结论选择自由体位分娩以及采取自然分娩,能够降低体胎儿体重偏大产妇的剖宫产率、降低阴道助产率,提高了分娩满意度,缓解了产妇分娩时的疼痛感,这对于促进自然分娩有着重要意义,值得临床推广与应用。

Objective To investigate the relationship between free labor and natural childbirth posture and postpartum care management. Methods A hospital in October 2014—2015 pregnant during August delivery in our hospital 150 cases, according to mode of delivery were divided into two groups, the control group and the observation group, 75 cases in each group, the control group of pregnant women traditional supine childbirth childbirth, the observation group of pregnant women using birth free position, you can select squatting, sitting, prone position, lateral position and an upright position, posture analysis free labor and natural childbirth relationship, as well as combined fetal position fetal weight evaluation of traditional liberal position and posture affect maternal and neonatal outcomes, respectively, and to evaluate their satisfaction with childbirth. Results The cesarean section rate 1.33%（1/75）, vaginal delivery rate of 2.67%（2/75）, episiotomy rate of 6.67%（5/75）, severe perineal laceration rate of 4.0%（3/75）, shoulder dystocia incidence 5.33%（4/75） in the control group cesarean rate 10.67%（8/75）, vaginal delivery rate of 16.0%（12/75）, episiotomy rate of 20.00%（15/75）, severe perineal laceration rate 10.67%（8/75）, the incidence of shoulder dystocia 12.00%（9/75）; observation group cesarean section rate, the rate of vaginal delivery, episiotomy rate of severe perineal laceration rate, shoulder dystocia incidence was significantly lower than the control group, significant difference was statistically significant（P〈0.05）; duration of labor in the observation group was significantly shorter than the control group, significant difference was statistically significant（P〈0.05）, the observation group maternity when the degree of pain was significantly lower than the control group, significant difference was statistically significant（P〈0.05）; the observation group maternity comfort significantly higher satisfaction, significant difference was statistically significant（P〈0.05）. Conclusion Freedom of choice position and take delivery of natural childbirth, fetal body weight can reduce maternal cesarean section rate is too large, reduce the rate of vaginal delivery, improve the delivery satisfaction, ease the pain for women during childbirth, which is for the promotion of natural delivery has important social value and significance worthy of promotion and application.