自由体位待产及分娩对活跃期初产妇分娩结局的影响分析

Effect of free position at predelivery and delivery on delivery outcome of primiparas in active phase

目的探究初产妇实施自由体位待产与传统卧位待产对产妇妊娠的影响。方法选取我院2014年7月~2015年6月收治的待产的初产妇共603例,所有初产妇按照入院时间顺序随机分为对照组与观察组。对照组产妇待产及分娩时采用传统平卧位,观察组患者采用自由体位待产及分娩,包括蹲位、坐位、侧卧位及直立位。比较两组初产妇分娩结局、并发症,第一、第二、总产程时间,及新生儿Apgar评分情况。结果观察组产妇经阴道顺产人数明显多于对照组,剖宫产人数明显少于对照组,差异有统计学意义（x2=13.4598,15.9780,P〈0.05）。观察组分娩并发症包括产后出血、会阴侧切,发生率为4.6%、2.7%,明显低于对照组,差异有统计学意义（P〈0.05）。观察组产妇第一、第二及总产程均明显短于对照组初产妇,差异有统计学意义（t=6.2519,22.9455,7.6608,P〈0.05）。两组产妇新生儿1、5、10min Apgar评分无明显统计学差异（P〉0.05）。结论初产妇实施自由体位待产及分娩可以有效缩短产程,并且可以降低分娩并发症,安全有效,值得临床产科推广使用。

Objective To explore the effects of free position and traditional lying position at predelivery on pregnancy of primiparas. Methods 603 primiparas who were admitted to our hospital to wait for delivery from July 2014 to June 2015 were selected and they were randomly divided into the control group and the observation group according to the order of admission time. Primiparas in the control group were received traditional lying position at predelivery and delivery. Primiparas in the observation group were received free position at predelivery and delivery including kneeling-squatting position, sitting position, lateral position and erect position. Delivery outcome, complications, first, second and total labor time, and neonatal Apgar score of two groups were compared. Results Primiparas with spontaneous delivery though vaginas in the observation group were significantly more than those of the control group while primiparas with cesarean section were significantly fewer than those in the control group. Differences were statistically significant, x^2=13.4598, 15.9780, P 〈0.05. Delivery complications of the observation group included postpartum hemorrhage and perineal side cut. Incidences of two complications were 4.6% and 2.7% respectively, significantly lower than those of the control group. The difference was statistically significant,P 〈0.05. The first stage, second stage and total stage of labor of the observation group were significantly shorter than those of the control group. The difference was statistically significant, t=6.2519, 22.9455, 7.6608, P0.05. In the two groups, there was no statistically significant difference in Apgar scores at 1min,5min, 10 min of primiparas and neonates, P 〈0.05. Conclusion For primiparas, application of free position at predelivery and delivery can effectively shorten the total stage of labor and reduce delivery complications. It is safe and effective, worthy of promotion and application in clinical obstetrics.