产前认知辅导对初产妇分娩方式及产程时间的影响

Effect of prenatal cognitive guidance on delivery mode and labor time in primipara

目的探讨产前认知辅导对初产妇分娩方式及产程时间的影响。方法选取2016年1~12月间我院妇产科收治的初产妇80例,依据随机数字表法分为产前常规检查组(n=40)和产前认知辅导组(n=40)。对两组初产妇的分娩方式、配合分娩情况及自然分娩初产妇的各阶段产程时间进行统计分析。结果产前认知辅导组初产妇的自然分娩率为75.0%(30/40)显著高于产前常规检查组52.5%(21/40)(P<0.05),剖宫产率、社会因素剖宫产率、难产率分别为22.5%(9/40)、5.0%(2/40)、22.5%(9/40)均显著低于产前常规检查组42.5%(17/40)、25.0%(10/40)、45.0%(18/40)(P<0.05),配合好比例[72.5%(29/40)]显著高于产前常规检查组[35.0%(14/40)](P<0.05),配合一般、配合差比例[22.5%(9/40)、5.0%(2/40)]均显著低于产前常规检查组[42.5%(17/40)、22.5%(9/40)](P<0.05),自然分娩初产妇的第二产程、总产程时间均显著短于产前常规检查组(P<0.05)。结论产前认知辅导能够有效提升初产妇的自然分娩率,降低初产妇的剖宫产率,并缩短自然分娩初产妇的产程时间。

Objective To explore the effect of prenatal cognitive guidance on the mode of delivery and the time of labor in primipara. Methods 80 cases of primipara who were admitted to the department of gynecology and obstetrics in our hospital from January to December 2016 were selected. The primipara were divided into two groups of regular examina- tion group （n=40） and prenatal cognitive guidance group（n=40） according to the random number table method. The de- livery mode, the delivery cooperation and the labor time of all stages of natural delivery in primipara were statistically analyzed in both groups. Results The natural delivery rate was 75.0% （30/40） in the primipara in the prenatal cognitive guidance group, which was significantly higher than that of 52.5%（21/40） in the prenatal regular examination group （P〈0.05）. Cesarean section rate, Cesarean section rate due to social factors and rate of dystocia were 22.5% （9/40）, 5.0% （2/40） and 22.5% （9/40） respectively, which were significantly lower than those of 42.5% （17/40）, 25.0% （10/40）, 45.0% （18/40） in the prenatal regular examination group （P〈0.05）. The proportion of favorable cooperation was 72.5% （29/40）, which was significantly higher than that of 35.0%（14/40） in the prenatal regular examination group （14/40） （P〈 0.05）. The proportions of moderate cooperation and poor cooperation were 22.5%（9/40） and 5.0%（17/40）, which were both lower than those of 42.5% （17/40） and 22.5% （9/40） in the prenatal regular examination group （P〈0.05）. The second stage of labor time and the total labor time in the natural delivery group were both significantly shorter than those in the prenatal regular examination group（P〈0.05）. Conclusion Prenatal cognitive guidance can effectively improve the natural delivery rate of primipara, reduce the rate of Cesarean section in primipara and shorten the time of labor in the primi- para with natural delivery.