第二产程应用不同分娩体位对会阴裂伤程度的临床效果观察

Effects of different positions during second stage of labor on degree of perineal laceration and episiotomy rate

目的探讨第二产程应用手膝俯卧位、侧卧位与平卧位接产对会阴裂伤程度及会阴侧切率。方法选取2017年8月至2018年4月期间在本院住院分娩的初产妇300例,根据产妇的意愿,最终胎儿娩出时的体位是手膝俯卧位、侧卧位者为观察组,平卧位者为对照组,各100例。三组产妇均应用无保护会阴接产,观察三组产妇会阴裂伤程度及会阴侧切率。结果手膝俯卧位组、侧卧位组与平卧位组会阴侧切率比较,差异有统计学意义(P<0.05);手膝俯卧位组与侧卧位组会阴侧切率比较,差异无统计学意义(P>0.05);三组产妇会阴III度、IV度裂伤比较,差异无统计学意义(P>0.05)。结论第二产程应用侧卧位、手膝俯卧位接产不增加会阴裂伤程度,应用手膝俯卧位、侧卧位接产会阴侧切率低且有效减轻会阴裂伤程度。

Objective To investigate the effects of hand and knee prone position,lateral position,and supine position during the second stage of labor on the degree of perineal laceration and episiotomy rate.Methods 300 primiparae who delivered in our hospital from August,2017 to April,2018 were selected,and were divided into a hand and knee prone position group,a lateral position group,and a supine position group,with 100 in each group.All the women took perineum delivery without protection.The maternal perineal laceration degrees and the episiotomy rates of the 3 groups were observed.Results There were statistical differences in the episiotomy rate between the hand and knee prone position group and the supine position group as well as between the lateral position group and the supine position group(P<0.05),but no between the hand and knee prone position group and lateral position group(P>0.05).There were no statistical differences in degree III and IV perineal laceration parturient between the three groups(P>0.05).Conclusion In the second stage of labor,the application of lateral recumbent position and lateral recumbent position for delivery does not increase the degree of perineal laceration,and has a low episiotomy rate.