胎儿脐带绕颈产妇第二产程应用改良McRobert体位分娩的临床研究

The Application of Improved McRobert Position in the Second Stage of Labor Among Delivery Women with Cord Around Neck

目的探讨胎儿脐带绕颈产妇第二产程中应用改良McRobert体位分娩对产妇生产的影响。方法选择鞍山市中心医院妇产科2016年3月-2017年3月收治的90例胎儿脐带绕颈产妇作为研究对象，随机分为A组45例，应用常规仰卧体位分娩；B组45例，应用改良McRobert体位分娩，对比两组产妇的分娩方式、第二产程时间、出血状况及新生儿状况。结果B组产妇的阴道分娩率高于A组产妇，差异有统计学意义（P〈0．05）。B组产妇的胎吸助产率和剖宫产率低于A组产妇，差异有统计学意义（P〈0．05）。B组产妇的第二产程时间和出血量低于A组产妇，新生儿Apgar评分高于A组产妇，差异均有统计学意义（P〈0．05）。结论胎儿脐带绕颈产妇在第二产程中应用改良McRobert体位分娩对产妇生产有积极影响，能够提高产妇的自然分娩率，缩短第二产程时间，减少产后出血，有利于新生儿的健康与安全。

Objective To investigate the effect of improved McRobert position in the second stage of labor on delivery women with cord around neck. Methods From March, 2016 to march, 2017, a total of 90 delivery women with cord around neck were recruited in Obstetrics and Gynecology Department, Anshan Central Hospital, and all women were randomly divided into A group （n=45 cases） and B group （n=45 cases）. The A group adopted regular supine position delivery, and B group adopted improved McRobert delivery, respectively. The delivery mode, second stage of labor time, bleeding and neonatal status were compared between two groups. Results The rate of vaginal delivery in B group was significantly higher than that in the A group （P〈0.05）. The rate of fetal midwifery and caesarean section in B group was significantly lower than that in the A group （P〈0.05）.The second stage of labor time and amount of bleeding in B group was significantly lower than those in the A group, and the neonate Apgar score in B group was significantly higher than that in the A group A （P〈0.05）. Conclusion Improved McRobert position in the second stage of labor among delivery women with cord around neck has positive impact on childbirth. It can improve the natural childbirth rate, shorten the time of the second stage of labor, reduce postpartum hemorrhage, and is beneficial to the health and safety for the newborns.