产妇分娩体位管理对分娩结局及新生儿的影响

Effect of maternal delivey positions management on pregnancy outcome and neonates

目的研究产妇不同分娩体位对分娩结局及新生儿的影响。方法选择2013年11月-2015年4月间在该院分娩的480例足月妊娠孕妇进行回顾性研究,根据孕妇的实际情况采用不同分娩体位,将足月妊娠孕妇回顾性分为仰卧位组、侧卧位组、半卧位组、蹲位组、坐位组及跪位组,每组80例。观察产妇产程进展、产后出血情况、产后会阴保护程度以及新生儿窒息发生情况。结果仰卧位组产妇平均产程较其余分娩体位组产妇平均产程长(P<0.01),而半卧位组产妇平均产程最短。坐位组产妇产后出血的情况最多,仰卧位组产妇产后出血的例数最少。蹲位分娩体位对产妇的会阴保护程度较其余分娩体位组产妇高(P<0.01)。跪位分娩体位对产妇的会阴保护程度较其余分娩体位组产妇低。仰卧分娩体位组产妇新生儿窒息发生率较其余分娩体位组产妇高(P<0.01)。结论仰卧分娩体位会增加产妇产程,新生儿窒息发生率也较其他分娩体位高。蹲位分娩体位对产妇会阴的保护程度较高。

Objective To research the effect of maternal delivey positions on pregnancy outcome and neonates. Methods A total of 480 full-term pregnant women giving birth to their babies in the hospital from November 2013 to April 2015 were selected and analyzed retro-spectively, then they were divided into dorsal position group, lateral position group, semireclining position group, kneeling-squatting position group, sitting position group, and kneeling position group according to maternal actual situations, 80 women in each group. The progress of labor, postpartum hemorrhage, the degree of postpartum perineal protection, and incidence rate of neonatal asphyxia were observed. Results The average time of stages of labor in dorsal position group was statistically significantly longer than those in the other five groups （P〈 0. 01 ）, the average time of stages of labor in semireclining position group was the shortest. The incidence rate of postpartum hemorrhage in sitting position group was the highest, while the incidence rate of postpartum hemorrhage in dorsal position group was the lowest. The degree of postpartum perineal protection in kneeling-squatting position group was statistically significantly higher than those in the other five groups （P〈0. 01 ）, the degree of postpartum perineal protection in kneeling position group was lower than those in the other five groups. The incidence rate of neonatal asphyxia in dorsal position group was statistically significantly higher than those in the other five groups （P〈0. 01 ） . Conclusion Delivery adopting dorsal position can prolong the stages of labor, and the incidence rate of neonatal asphyxia is higher than those adopting other delivey postures. The degree of postpartum perineal protection when adopting kneeling-squatting position is higher compared with adopting other delivey postures.