无痛分娩下新产程标准管理对母婴结局的影响

Effect of standard management of new labor in painless delivery on maternal and child outcomes

目的探讨无痛分娩下新产程标准管理对母婴结局的影响。方法选取2015年9月~2018年9月于我院住院待产的初产妇共98例,采用随机数字表法将其分为观察组和对照组,每组各49例。两组均进行无痛分娩,观察组给予新产程标准进行管理,对照组给予传统产程标准管理,比较两组的产程时间、视觉模拟量表(VAS)评分、第一产程医疗干预情况、分娩方式及母婴结局。结果观察组第一、二产程时间及总产程时间均长于对照组(P<0.05);观察组VAS评分低于对照组(P<0.05);观察组第一产程人工破膜率、静滴缩宫素率及总干预率低于对照组(P<0.05);观察组自然分娩率高于对照组(P<0.05);观察组中途转剖宫产率显著低于对照组(P<0.05);两组产后出血、产后尿潴留、新生儿窒息及胎儿窘迫的发生率比较,差异无统计学意义(P>0.05);观察组产妇会阴侧切率显著低于对照组(P<0.05)。结论无痛分娩采用新产程标准管理产程延长了产程时间,给予产妇充分试产,有效提高自然分娩率,降低剖宫产率,安全性更高,值得临床推广。

Objective To explore the effect of standard management of new labor in painless delivery on maternal and child outcomes.Methods A total of 98 primiparas who were hospitalized in our hospital from September 2015 to September 2018.They were divided into the observation group and the control group according to random number table method,49 cases in each group.All of which were painlessly delivered.The observation group was managed with new labor standards and the control group was given traditional labor standard management.The labor time,Visual analog scale (VAS) score,first stage medical intervention,mode of delivery and maternal and child outcomes were compared between two groups.Results The first and second labor time and total labor time of the observation group were longer than the control group (P<0.05).The VAS score of the observation group was lower than that of the control group (P<0.05).The rate of artificial rupture of membrane,the rate of intravenous Oxytocin and the total intervention rate in the first stage of the observation group were lower than those in the control group (P<0.05).The natural delivery rate of the observation group was higher than that of the control group (P<0.05).The low yield of cesarean section in the observation group was significantly lower than that in the control group (P<0.05).There was no significant difference in the incidence of postpartum hemorrhage,postpartum urinary retention,neonatal asphyxia and fetal distress between the two groups (P>0.05).The rate of perineal cut in the observation group was significantly lower than that in the control group (P<0.05).Conclusion The use of new labor standards to manage labor during painless delivery prolongs the labor process,gives the mother full trial production,effectively increases the natural delivery rate,reduces the cesarean section rate,and has higher safety.It is worthy of clinical promotion.