三组不同分娩体位对孕产妇母儿结局的影响

Effects of three different delivery positions on the maternal and infant outcomes

目的探讨仰卧位、侧卧位和俯卧位三组不同分娩体位对孕产妇母儿结局的影响。方法选择2018年3月-2019年3月在佛山市南海区第六人民医院选择自然分娩的产妇300例,随机分为仰卧位组、侧卧位组和俯卧位组,每组100例。比较三组产妇妊娠结局(顺产率、剖宫产率、第二产程时间、产后2 h出血量)、产妇疼痛及焦虑感和胎儿心率,评价不同的分娩体位对孕产妇的影响。结果比较三组产妇的顺产率,发现俯卧位和侧卧位产妇顺产率均显著高于仰卧位,差异具有统计学意义(P <0.05);比较三组产妇的疼痛及焦虑情况发现,侧卧位和俯卧位分娩可以降低产妇的疼痛感和焦虑感,差异具有统计学意义(P<0.05);比较三组产妇的第二产程时间和产后2 h出血量发现,侧卧位和俯卧位分娩的产妇第二产程时间稍高于仰卧位组产妇,侧卧位和俯卧位分娩的产妇产后2 h出血量稍低于仰卧位组产妇,但差异均无统计学意义(P>0.05);比较三组产妇胎儿胎心正常率发现,侧卧位分娩和俯卧位分娩胎儿胎心正常率显著高于仰卧位,差异具有统计学意义(P <0.05)。结论产妇在第二产程分娩的过程中采取俯卧位和侧卧位分娩,可以提高孕产妇的顺产率,降低产妇分娩过程中的疼痛感和焦虑感,胎儿胎心的正常发生率也显著升高,达到改善孕产妇母儿结局的目的,是促进自然分娩的有效方式,值得在临床上进一步推广应用。

Objective To explore the effects of three different delivery positions on maternal and infant outcomes.Methods From March 2018 to March 2019,300 natural parturients who were selected to give birth in our hospital were randomly divided into the supine position group,the lateral position group and the prone position group,with 100 cases in each group.The pregnancy outcomes(natural birth rate,cesarean section rate,second labor duration,postpartum 2 hours blood loss),maternal pain and anxiety,and fetal heart rate were compared among the three groups,and the effects of different delivery positions on the pregnant women were evaluated.Results The rateof natural birth in the lateral position group and the prone position group was significantly higher than that in the supine position.By comparing the pain and anxiety of the three groups,it was found that the lateral position and the prone position can reduce the pain and anxiety of the puerpera.By comparing the second labor duration and postpartum 2 h blood loss in the three groups,it was found that the second labor duration in the lateral position and the prone position was slightly higher than that in the supine position,and the postpartum 2 h blood loss in the lateral position and the prone position was slightly lower than that in the supine position,but the difference was not statistically significant(P> 0.05).Comparing the normal rate of fetal heart in the three groups,it was found that the normal rate of fetal heart in the lateral position group and the prone position group was significantly higher than that in the supine position group.Conclusion The delivery in the prone position and the lateral position during the second stage of labor can improve the natural birth rate of pregnant women..They can also reduce the maternal pain and anxiety in the process of childbirth,and significantly increase the normal fetal heart rate.It can achieve the goal of improving maternal and fetal outcomes.It is an effective way to promote natural childbirth,and is worth further popularizing and applying in clinic.