助产士引导的全程心理干预联合导乐分娩对初产妇心理及母婴结局的影响

Effect of midwife-guided full-course psychological intervention combined with doula delivery on primipara psychology and maternal and neonatal outcomes

目的分析助产士引导的全程心理干预联合导乐分娩对初产妇心理及母婴结局的影响。方法选取2017年2月至2018年3月于我院分娩的102例初产妇作为研究对象,采用随机数表法将其分为对照组与观察组,每组51例。对照组给予导乐分娩,观察组在对照组的基础上给予全程心理干预。比较两组的心理、疼痛评分、产程时间及母婴结局。结果观察组的SDS、SAS及VAS评分均低于对照组(P<0.05)。观察组产妇第一、二、三产程时间及总产程时间均短于对照组(P<0.05)。两组产妇的阴道助产率、剖宫产率与产褥期感染率比较,差异无统计学意义(P>0.05);观察组的产妇阴道分娩率及新生儿5 min Apgar评分均高于对照组,产后出血量少于对照组,卧床时间短于对照组(P<0.05)。结论助产士引导的全程心理干预联合导乐分娩可减轻初产妇的心理负担,缩短总产程时间,提高产妇阴道分娩率,改善母婴结局。

Objective To analyze the effect of midwife-guided full-course psychological intervention combined with doula delivery on primipara psychology and maternal and neonatal outcomes. Methods A total of 102 primiparas delivered in our hospital from February 2017 to March 2018 were selected as the study objects, and they were divided into control group and observation group by random number table method, with 51 cases in each group. The control group was given doula delivery, and the observation group was given full-course psychological intervention on the basis of the control group.The scores of psychological, pain, duration of labor and maternal and neonatal outcomes were compared between the two groups. Results The scores of SDS, SAS and VAS in the observation group were lower than those in the control group(P<0.05). The first, second and third stages of labor and the total duration of labor in the observation group were shorter than those in the control group(P<0.05). There were no significant differences in vaginal deliver rate, cesarean section rate and puerperal infection rate between the two groups(P>0.05);the vaginal delivery rate of primipara and Apgar score of 5 min in the newborn in the observation group were higher than those in the control group, the amount of postpartum hemorrhage was less than that in the control group, and the time of lying in bed was shorter than that in the control group(P<0.05).Conclusion Midwife-guided full-course psychological intervention combined with doula delivery can reduce the psychological burden of primipara, shorten the total delivery time, improve the vaginal delivery rate and improve the maternal and neonatal outcomes.