产道保护凝胶对初产妇经阴道分娩中软产道及盆底的保护作用

Protective effect of an obstetric gel on the soft birth canal and pelvic floor in primiparous vaginal delivery

目的探讨一种新型产道保护凝胶对初产妇经阴道分娩中软产道及盆底的保护作用。方法纳入足月经阴道分娩的初产妇273例,采用随机信封法分为产道保护凝胶助产实验组(R组)、传统方式产道保护组(T组)和常规助产对照组(C组),每组91例。观察产后软产道损伤、产程时长、盆底机能康复及不良反应发生情况。结果R组宫颈裂伤发生率、血肿发生率、会阴侧切率均明显低于T组和C组(均P<0.05)。在已侧切情况下,R组未出现宫颈、阴道和会阴裂伤,T组宫颈裂伤发生率为4.05%,C组为8.24%,均明显高于R组(P<0.05)。R组与T组和C组比较,第一产程、第二产程平均时长均明显缩短(均P<0.05)。产后对R组产妇及胎儿进行随访,未发现胎儿及软产道皮肤过敏、胎儿误吸等不良反应,R组与T组和C组比较,产后软产道感染的发生率无统计学差异(P>0.05)。产后42 d检测盆底机能评分,R组盆底机能评分明显高于T组和C组(P<0.05),T组和C组比较差异无统计学意义(P>0.05)。结论产道保护凝胶用于初产妇经阴道分娩可以软化宫颈、促进宫颈成熟,增加软产道延展性和润滑度,缩短第一产程、第二产程,减少软产道损伤,起到保护作用,并且间接保护盆底功能,非常值得推荐广泛用于阴道分娩助产。

Objective To examine the protective effect of an obstetric gel on the soft birth canal and pelvic floor in primiparous vaginal delivery.Methods A total of 273 primiparas who had vaginal delivery were selected and randomly divided into three groups:gel protection group(group R),traditional protection group(group T),and conventional midwifery group(group C;n=91 in each group).Soft birth canal injury,labor duration,recovery of pelvic floor function,and adverse effects were observed.Results The incidences of cervical fracture,uterine hematoma,and perineal incision were significantly lower in group R than in groups T and C(P<0.05).After lateral episiotomy,the incidences of cervical,vaginal,and perineal lacerations were significantly higher in groups T(4.05%)and C(8.24%)than in group R(0%;P<0.05).The mean durations of the first and second stages of labor in group R were significantly shorter than those of the first and second stages of labor in groups T and C(P<0.05).No adverse effects were found in group R,and no significant difference in the incidence of soft birth canal infection was found between the groups(P>0.05).The pelvic floor function score 42 days after birth was significantly higher in group R than in groups T and C(P<0.05),with no significant difference between groups T and C.Conclusion The new obstetric gel can shorten labor duration,reduce the incidence of soft birth canal injury,and protect pelvic floor function in primiparous vaginal delivery.