采用自由体位促进产程及自然分娩的临床效果

The clinical effect of free body position on promoting natural delivery

目的:观察采取自由体位促进初产妇第一、二产程及自然分娩的临床效果。方法:选取2013年6月至2014年2月龙游县中医院住院分娩的第一胎足月初产妇240例,随机分为对照组和观察组,各120例。对照组整个产程采取常规截石位,屏气,用力分娩;观察组在分娩第一、二产程中由产妇根据自己的意愿采取不同体位(侧卧、坐、站、行、趴、蹲等),接生时采取截石位。比较2组产妇宫口扩张情况、先露下降情况、产程时间、分娩方式、产后出血量、新生儿Apgar评分及护理满意度。结果:观察组自然分娩的比例显著高于对照组;观察组产后出血量和自然分娩总产程均明显低于对照组;观察组新生儿Apgar评分≥8分者明显多于对照组;观察组对护理的满意度明显高于对照组,2组比较差异均有统计学意义(P<0.01)。结论:初产妇在分娩第一、第二产程中采取自由体位,可提高自然分娩率,缩短分娩产程,保护母婴安全,提高护理满意度。

Objective： To study the effects of free position during the first and second stages of labor on natural delivery. Methods： A total 240 of pregnant women who delivered in our hospital were enrolled into this study from June 2013 to February 2014. They were randomly divided into observation and control group, with 120 cases in each. Women in the control group took lithotomy position the whole process, held breath and gave birth hard. For observation group, women could freely chose any comfortable body position such as lying, walking,standing, sitting, kneeling, creeping or squatting on delivery during the first and second stage of labor, and used lithotomy position when delivering. The effects between two groups were observed and compared in terms of uterine cervix dilatation, time of the labor duration, maternal postpartum hemorrhage rate, neonatal Apgar score and postpartum discomfort rate. Results： The natural delivery rate of the observation group was significantly higher than the control group（P〈0.05）. The time of total labor and the maternal postpartum hemorrhage rate of the observation group was less than the control group（P〈0.05）. The neonatal Apgar score≥8 of the observation group was obviously better than that of control group（P〈0.05）. Satisfaction rate of pregnant women in the observation group was higher than that of the control group. There＇s statistical difference（P〈0.05） between the two groups. Conclusion： Freely chosen body positions during the first and second stages of labor process can promote natural delivery, shorten the time of labor, reduce maternal and neonatal complications and secure the health of mothers and babies. Besides, it improves satisfaction degree of pregnant women and the skills and competency of health care workers.