两种体位矫正持续性枕后位提高自然分娩成功率及妊娠结局分析

The improvement of the success rate of spontaneous delivery and pregnancy outcome after two postural correction of persistent occipital posterior position

目的研究两种体位在矫正持续性枕后位中的价值。方法回顾性分析2013年4月至2015年4月在陕西旬阳县妇女儿童医院经B超等检查明确诊断为持续性枕后位的110例产妇的临床资料,根据在分娩过程中采用的不同体位分为侧卧组(54例)和仰卧组(56例),对比两组产妇分娩状况、产程异常情况以及产妇和新生儿结局等。结果侧卧组阴道自然分娩构成比(66.67%)明显高于仰卧组(30.36%);阴道撕裂构成比(3.70%)显著低于仰卧组(21.43%);侧卧组产妇的活跃期以及其他产程明显缩短,总产程时间[(10.98±2.61)h]明显低于仰卧组[(16.38±3.01)h];侧卧组新生儿阿氏评分较高,为(9.16±0.33)分,胎儿出生后出现不良反应的情况(12.96%)明显少于仰卧组(75.00%);产后出血的概率也较低,差异均有统计学意义(P<0.05)。结论在分娩过程中,采用先同侧后对侧侧卧位或先对侧后同侧侧卧位,可明显改善胎位,提高自然分娩的概率,减少胎儿和产妇的损伤,改善围产结局。

Objective To study the value of two postures in the correction of persistent occipital posterior position .Methods 110 pregnant women diagnosed as persistent occipital posterior position by B ultrasonic or other examination in Women and Children’ s Hospital of Xunyang County from April 2013 to April 2015 were selected,according to different positions in birth process ,they were divided into lateral group（54 cases） and supine group（56 cases）, the abnormal birth process and the maternal and neonatal outcomes of the two groups were observed .Results The constituent ratio of maternal vaginal delivery of lateral group （ 66.67 %） was significantly higher than that of supine group （30.36 %） while the constituent ratio of vaginal tearing of lateral group （3.70 %） was significantly lower than that of supine group （ 21.43 %） .The differences were statistically significant （ P〈0.05 ） .The active phase and other stages of labor of the lateral group shortened obviously with total labor time [ （10.98 ±2.61） h] significantly lower than that in the supine group[（16.38 ±3.01） h].The difference was statistically significant （P〈0.05）.Apgar scoring of the lateral group （9.16 ±0.33） was higher,and adverse reaction of newborns （12.96 %） was less than that of supine group （75.00 %）.Postpartum hemorrhage was less , too.The differences were statistically significant （ P〈0.05） .Conclusion In the process of delivery , using the correct body position can improve the probability of natural childbirth and reduce damage to fetus and mother .