自由体位分娩与传统分娩方式在产程管理中的对比分析

Comparative on Management of Labor and Birth Between Freedom in Position and Routine Lithotomy Position Throughout Labor

观察自由体位分娩过程中采用新的产程管理对分娩结局的影响。将符合要求的孕妇随机分为试验组及对照组各124例,试验组采取自由体位分娩,按照新的产程标准管理;对照组采用平卧位分娩,按现行产程标准管理。试验组第1、2产程及总产程较对照组明显延长,差异有统计学意义(P<0.05);试验组顺娩122例,中转剖宫产2例,对照组顺娩94例,剖宫产30例,差异有统计学意义(P<0.001);两组孕妇产后出血量、会阴裂伤、肩难产、新生儿窒息率等均差异无统计学意义(P>0.05)。应用新的产程管理,显著降低了剖宫产率,但并未增加母儿不良结局。

To explore the impact of freedom in birth position throughout labor on the maternal and neonatal outcomes under the Consensus Statement on New Standard and Management of labor process. 248 women were randomly assexperimental group （n= 124） and control group （n= 124）. Women in the experimental group had the freedom of choice of birth positions throughout labor and were managed under the Consensus Statement on New Standard and Management of labor process. Women in the control group were instructed to use back-lying or semi-lying position% and then use routine lithotomy position to push throughout the labor. The management of the process of labor and birth followed the current standard. The total time of the first and second stage of labor of the treatment group was obviously longer than that of the control group （D〈0. 05）. Women in the treatment group had 122 cases （98. 4%） of normal physiologic （1. 6%） of emergency cesarean delivery; while women in the control group had 94 cases （75. birth and 30 cases （24. 2 % ） of emergency cesarean delivery（P〈0. 001）. There was no statistical difference between the two groups in blood loss% episiotomy and perineal tear% shoulder dystocia% asphyxia and baby weight （P＆0. 05）. No adverse events of the mothers and babies were observed in this study. Based on the new management standard of labor and birth% it decreases the rate of cesarean delivery% but did not increase adverse events of the mother and baby.