不同待产体位对足月头位衔接的胎膜早破孕妇分娩结局的影响

Effects of Different Postures on Expectant Membranes in Head Position between Premature Rupture of the Maternal and Neonatal Outcomes

目的:研究妊娠足月,先露为头,而且胎头已衔接的胎膜早破孕妇,采用不同待产体位分娩,对于分娩结局的影响。方法:从近期在笔者所在医院产科住院分娩的孕妇中,选取80例孕妇,要求孕妇的孕周≥37周,先露为头,而且胎头已经衔接,按入院的先后顺序,将其分为两组,每组40例,A组待产过程中采用自由体位,而B组采用绝对卧床,并抬高臀部的体位。对比两组孕妇的分娩结局。结果:采用自由体位的A组阴道分娩成功率为77.50%,而采用抬高臀部的B组自然分娩成功率为52.50%,差异有统计学意义(P<0.05);而A组第一产程、第二产程时间均明显短于B组,差异有统计学意义(P<0.05);A组羊水流出量也明显少于B组,差异有统计学意义(P<0.05);A组产后尿潴留发生率为2.50%,B组为15.00%,差异有统计学意义(P<0.05);A组会阴侧切率为12.50%,B组为30.00%,差异有统计学意义(P<0.05)。结论:妊娠足月,先露为头,而且胎头已衔接的胎膜早破孕妇,在待产的过程中,采用自由体位,可以明显缩短产程时间、降低会阴侧切率,减少产后并发症的发生,值得临床推广应用。

Objective： To study the effect of different postures on outcomes of premature rupture of membranes in full-term pregnancy with presentation for the head and fetal head cohesion.Method： 80 pregnant women in the author＇s hospital were selected, with gestatlonal age more than or equal to 37 weeks, presentation for the head, and the head has cohesion, according to the order of admittance they were divided into two groups, with 40 cases in each group, group A pregnant women with free position, and group B with absolute bed, and raised the buttocks position.The delivery outcomes of the two groups were compared. Result： The success rate of vaginal delivery was 77.50% in group A, and the group B was 22.50%, the difference was statistically significant（P〈0.05）.The fi^t and second stage of labor time in group A was significantly shorter than group B, the difference was statistically significant（P〈0.05）.The amniotic fluid volume of group A was less than group B, the difference was statistically significant（P〈0.05）.The incidence of postpartum urinary retention of group A was 2.50%, the group B was 15.00%, the difference was statistically significant（P〈0.05）.The rate of lateral episiotomy was 12.50% in A group, group B was 30.00%, the difference was statistically significant（P〈0.05）.Conelnsion： Pregnancy, presentation for the head, and fetal head between premature rupture of fetal membranes in the labor process, the free position, can shorten the labor time, reduce the probability of episiotomy, reduce the occurrence of postpartum complications, worthy of clinical application.