无创助产技术用于高龄初产妇自然顺产对母婴结局及性生活质量的影响

Effect of Non-invasive Midwifery on Maternal and Infant Outcomes and Quality of Sexual Life in Elderly Primipara

目的:探讨正位无创助产技术应用于高龄初产妇自然顺产的母婴结局及性生活质量的影响。方法:选取本院2015年1月-2017年12月入住产科的自然分娩的高龄初产妇62例,采用红篮球法将产妇分为观察组(31例)、对照组(31例)。观察组采用正位无创助产技术,对照组采用传统助产方式。对比两组产妇及新生儿情况,并于分娩后6个月对两组性生活质量进行评估。结果:观察组会阴侧切率为0,明显低于对照组100%(P<0.01);观察组会阴裂伤程度明显高于对照组(P<0.01),两组会阴肿胀发生率比较,差异无统计学意义(P>0.05);观察组新生儿1、5 min的Apgar评分明显优于对照组(P<0.05);观察组产妇产后6个月女性性功能指数量表(female sexual function index,FSFI)除性高潮外各维度评分及总分均明显高于对照组(P<0.01);观察组产后6个月女性性苦恼量表(female sexual distress scale-recised,FSDS-R)总分明显低于对照组(P<0.01);结论:正位无创助产技术适用于高龄初产妇,能够有效减少会阴侧切风险,但会造成Ⅰ度会阴裂伤,有助于改善新生儿评分及产妇产后的性生活质量,降低产妇性苦恼程度,对高龄初产妇及其新生儿有积极影响。

Objective:To investigate the effect of orthotopic non-invasive midwifery on maternal and infant outcomes and quality of sexual life in elderly primipara.Method:62 elderly primipara admitted to obstetrics from January 2015 to December 2017 were selected and divided into observation group(31 cases)and control group(31 cases)by red basketball method.The observation group adopted orthotopic non-invasive midwifery and the control group adopted traditional midwifery.The situation of parturients and newborns in the two groups were compared,and the quality of sexual life in the two groups were evaluated at 6 months after delivery.Result:The rate of perineal lateral resection in observation group was 0 significantly lower than 100%in control group(P<0.01).The degree of perineal laceration in observation group was significantly higher than that of the control group(P<0.01).There was no significant difference in the incidence of perineal swelling between the two groups(P>0.05).The Apgar scores of neonates in observation group at 1 min and 5 min were significantly better than those in control group(P<0.05).The female sexual function index(FSFI)scores and total scores of all dimensions except orgasm at 6 months after delivery in the observation group were significantly higher than those in the control group(P<0.01),and the total score of female sexual distress scale-recised(FSDS-R)in the observation group was significantly lower than that in the control group at 6 months after delivery(P<0.01).Conclusion:The technique of orthotopic non-invasive midwifery can effectively reduce the risk of perineal lateral incision,but it will result inⅠdegree perineal laceration.It is helpful to improve neonatal score and the quality of postpartum sex life,and reduce the degree of sexual distress of pregnant women.It has a positive effect on the elderly primipara and their newborns.