连续性助产护理模式对孕妇分娩结局的影响

Effect of continuity of midwifery service model on delivery outcomes in pregnant women

目的探讨连续性助产护理模式对孕妇分娩结局的影响。方法选择2015年1月至2016年6月在本院接受连续性助产护理模式的单胎头位产妇100名为观察组，同期未接受连续性助产护理模式的单胎头位产妇100名为对照组。对2组产妇的分娩方式、孕期体质量增长、会阴侧切率、总产程时间、产后出血率、新生儿窒息率、巨大儿发生率进行比较。结果 观察组的孕期体质量增长、总产程时间分别为（12.26 ± 0.95）kg、（445.21 ± 246.34）min，对照组分别为（14.48 ± 1.89）kg、（642.26 ± 258.81）min，2组比较差异有统计学意义（t=-10.534、-3.456，均P〈0.01）；观察组剖宫产率、产后出血率、巨大儿发生率分别为29%（29/100）、2%（2/100）、3%（3/100）,对照组分别为45%（45/100）、10%（10/100）、12%（12/100），2组比较差异有统计学意义（χ2=7.040、5.674、5.838，均P〈0.05）；观察组会阴侧切、新生儿窒息例数分别为26、0名，对照组分别为30、2名，2组比较差异无统计学意义（χ2=1.109、2.020，均P〉0.05）。结论实施连续性助产护理模式可以有效地促进自然分娩，降低巨大儿及产后出血的发生率，提升了产科服务能力，提高了自然分娩质量，是一种值得临床推广应用的护理模式。

Objective To explore the effect of continuity of midwifery service model on delivery outcomes in pregnant women.Methods From January 2015 to June 2016,100 single pregnant women with full-term and cephalic presentation who accepted midwife outpatient education were selected from our hospital and divided into observation group, at the same time,100 cases of full-term and cephalic presentation accepting obstetrics regular check as control group. Both delivery methods and total labor time were compared between two groups; the rates of episiotomy, weight gain during pregnancy, postpartum hemorrhage, neonatal asphyxia and macrosomia were all observed.Results The observation group maternal weight gained, the total labor time were （12.26±0.95） kg, （445.21±246.34） min, the control group were （14.48± 1.89） kg, （642.26±258.81） min, there wwa significant difference （t=-10.534,-3.456, P 〈 0.01）.The observation group cesarean section rate, postpartum hemorrhage rate, the rate of fetal macrosomia were 29% （29/100）, 2% （2/100）, 3% （3/100）, the control group were 45% （45/100）,10% （10/100）,12% （12/100）, there was significant difference （χ2=7.040, 5.674, 5.838, P 〈 0.05）. In the observation group, the rate of perineal resection were 26% （26/100） and 0 respectively, the control group were 30% （30/100） and 2% （2/100）, there was no difference between the two groups （χ2=1.109, 2.020, P 〉 0.05）.Conclusions Continuous care provided by midwife can effectively promote natural birth, reduce the incidences of macrosomia and postpartum hemorrhage, enhance the quality of obstetric services, is worth promoting in clinical application.