不同待产体位对足月头位已衔接的胎膜早破孕妇分娩结局的影响

Effect of different postures on the delivery outcome of pregnant women with premature rupture of membranes in full-term cephalic position

目的探讨足月头位已衔接的胎膜早破(PROM)孕妇不同待产体位对分娩结局的影响。方法选取西北妇女儿童医院妇产科2016年8月至2019年6月期间收治入院的足月头位已衔接PROM孕妇124例为研究对象,按照随机数表法分为对照组和观察组各62例。对照组采用平卧和侧卧臀高位至宫口全开,观察组入院后不限制体位,至宫口全开,观察两组孕妇的分娩结局。结果观察组孕妇的阴道分娩率为72.58%,明显高于对照组的51.61%,差异有统计学意义(P<0.05);观察组孕妇产前流出羊水量为(107.25±50.21) mL,明显少于对照组的(242.65±69.18) mL,第一产程及第二产程分别为(8.56±2.36) h、(0.96±0.15) h,明显短于对照组的(10.58±3.96) h、(1.64±0.19) h,差异均有统计学意义(P<0.05);观察组阴道分娩孕妇不良事件发生率为6.67%,明显低于对照组的28.13%,差异有统计学意义(P<0.05)。结论足月头位已衔接的PROM孕妇采用自由待产体位可减少阴道分娩流出羊水量,缩短产程,提升阴道分娩率。

Objective To investigate the effect of different postures on delivery outcome of pregnant women with premature rupture of membranes(PROM) in full-term cephalic position. Methods A total of 124 pregnant women with PROM who were admitted to Northwest Women and Children Hospital from August 2016 to June 2019 were divided into two groups according to random number table, with 62 women in each group. The control group was treated with supine and lateral supine buttocks from high position to full opening of the uterine mouth, while the observation group was not restricted posture after admission to full opening of the uterine mouth. The outcome of vaginal delivery was observed in both groups. Results The rate of vaginal delivery in the observation group was 72.58%, which was significantly higher than 51.61% in the control group(P<0.05). The amount of amniotic fluid flowed out before delivery in the observation group was less than that in the control group:(107.25±50.21) mL vs(242.65±69.18) mL;the time of the first and second stages of labor was shorter than that in the control group:(8.56±2.36) h vs(10.58±3.96) h,(0.96±0.15) h vs(1.64±0.19) h;the differences were statistically significant(P<0.05). The incidence of adverse events in the observation group was significantly lower than that in the control group(6.67% vs 28.13%, P<0.05). Conclusion Free posture can reduce the amount of amniotic fluid flowed out of vaginal delivery, shorten the course of labor and increase the rate of vaginal delivery for pregnant women with PROM in full-term cephalic position.