深水位水中分娩对产妇及新生儿的影响

Effects of water birth in deep water level on maternal and newborns

目的研究深水位水中分娩对产妇及新生儿的影响。方法选择2014年4月—2016年5月在温州东方妇产科医院水中分娩的初产妇132例,按照分娩过程中水位的高低将其分为低水位组62例和深水位组70例,低水位组水位至腰部,深水位组水位至胸部,并选择同期进行常规分娩的产妇65例,记为对照组,比较3组产妇的总产程、24 h出血量、会阴损伤程度以及疼痛程度,同时采用Apgar评分评价新生儿的健康状况,并记录新生儿NICU入住率以及新生儿感染率。结果 3组产妇24 h出血量比较差异无统计学意义(P>0.05),总产程、会阴损伤比较,差异有统计学意义(均P<0.05),深水位组总产程明显低于低水位组和对照组(P<0.05),低水位组总产程明显低于对照组(P<0.05),深水位组会阴损伤程度明显低于低水位组和对照组(均P<0.05),低水位组会阴损伤程度明显低于对照组(P<0.05);深水位组Ⅰ级疼痛17例,Ⅱ级疼痛33例,Ⅲ级疼痛16例,Ⅳ级疼痛4例;低水位组Ⅰ级疼痛6例,Ⅱ级疼痛17例,Ⅲ级疼痛31例,Ⅳ级疼痛8例;对照组Ⅰ级疼痛4例,Ⅱ级疼痛10例,Ⅲ级疼痛24例,Ⅳ级疼痛27例,深水位组疼痛程度明显低于低水位组和对照组(均P<0.05),低水位组疼痛程度明显低于对照组(P<0.05);3组新生儿1 min和5 min Apgar评分比较差异均无统计学意义(均P>0.05),3组NICU入住率和新生儿感染率比较差异无统计学意义(均P>0.05)。结论深水位水中分娩优于低水位水中分娩,可以明显缩短产程,降低会阴损伤程度,减轻产妇疼痛,且对新生儿无严重不良影响。

Objective To study the effects of water birth in deep water level on maternal and newborns. Methods One hundred and thirty-two primiparous women adopting water birth in our hospital from April, 2014 to May, 2016 were divid- ed into low water level group （62 cases） and deep water level group （70 cases） according to the level of water level during delivery, water level to the waist in the low water level group, and water level to the chest in the deep water level group, and choose the same period in our hospital for routine delivery of maternal 65 cases, recorded as the control group, comparison of the threegroups of total stage of labor, 24 h bleeding volume, perineal injury and pain, at the same time, the Apgar score was used to evaluate the newborns health status and the newborns NICU occupancy rate and newbo- rns infection rate were recorded. Results There was no significant difference in blood loss between the three groups （ P 〉 0.05 ）, there was statistically significant in total labor and perineum injury between the three groups （ P 〈 0.05 ）, the total stage labor of the deep water level group was significantly lower than that of the low water level group and control group （ P 〈 0.05 ）, the total stage labor of the low water level group was significantly lower than that of the control group （ P 〈 0.05 ）, the degree of perineum injury in the deep water level group was significantly lower than that in the low water level group and control group （P 〈 0.05 ）, the degree of perineum injury in the low water level group was significantly lower than that in the control group （P 〈 0.05）. Seventeen cases of grade Ⅰpain, 33 cases of grade Ⅱ pain, 16 cases of grade Ⅲ pain, 4 cases of grade Ⅳ pain in the deep water level group, 6 cases of grade Ⅰ pain, 17 cases of grade Ⅱ pain, 31 cases of grade Ⅲ pain, 8 cases of grade Ⅳ pain in low water level group, 4 cases of gradeⅠ pain, 10 cases of grade Ⅱ pain, 24 cases of grade Ⅲ pain, 27 cases of grade Ⅳ pain in low water level group, the degree of pain in the deep water level group was significantly lower than that in the low water level group and control group（ P 〈 0.05 ）, the de- gree of pain in the low water level group was significantly lower than that in the control group （ P 〈 0.05） ; There was no significant difference in Apgar scores between the three groups at 1min and 5 rain （P 〉 0.05 ）, and there was no signifi- cant difference between the threegroups in NICU occupancy rate and neonatal infection rate （P 〉 0.05 ）. Conclusion Deep water level in the delivery of water is better than low water level in childbirth, can significantly shorten the labor, reduce the degree of perineal injury, reduce maternal pain, and no serious adverse effects on neonatal.