妊娠26周至产后42天Kegel运动对分娩结局和产妇盆底功能的影响

Effect of kegel exercise on the delivery outcome and pelvic floor muscle function of parturients

目的探讨妊娠26周至产后42天Kegel运动对产妇分娩结局和盆底功能的影响。方法回顾性选取2018年3月至2019年12月在福建医科大学漳浦教学医院门诊检查的180例初产妇,根据是否进行Kegel运动分为观察组(n=89)和对照组(n=91),观察组产妇从妊娠26周开始至产后42 d进行Kegel运动,对照组产妇正常产检,不进行Kegel运动。观察两组产妇的分娩结局和产后盆底功能的情况。结果观察组产妇孕晚期的非尿失禁率(46.07%)、阴道分娩率(97.75%)、会阴完整率(28.74%)、产后42 d盆底肌张力评分(深I类3.3±1.5分;浅I类2.7±1.3分;深II类3.6±1.4分,浅II类3.4±1.5分)明显高于对照组(23.08%;86.81%;15.19%;深I类2.4±1.7分,浅I类1.6±1.2分,深II类2.3±1.5分,浅II类2.2±1.7分),差异具有统计学意义(P<0.05)。观察组产妇各阶段的产程时间(第一产程430.9±41.7 min;第二产程45.9±1.4 min;第三产程5.8±1.5 min;总产程482.6±44.6 min)、会阴侧切率(13.79%)、会阴撕裂严重程度(会阴撕裂I度94.00%;会阴撕裂II度4.00%)、产后盆底功能恢复正常的时间(25.8±1.7 d)明显低于对照组(第一产程547.6±52.5 min,第二产程54.6±1.2 min,第三产程7.9±1.7 min,总产程610.1±55.4 min;26.58%;会阴撕裂I度71.74%,会阴撕裂II度19.56%;36.5±1.9 d),差异具有统计学意义(P<0.05);观察组与对照组两组产妇的助产率(9.20%vs.12.66%)、新生儿窒息率(1.12%vs.5.49%)、产后出血率(1.12%vs.4.40%)、尿潴留率(1.12%vs.6.59%)比较,差异无统计学意义(P>0.05)。结论妊娠26周开始至产后42 d进行Kegel运动可显著改善产妇的分娩结局,提高产后的盆底功能。

Objective To explore the effect of Kegel exercise on the delivery outcome and pelvic floor muscle function of parturients from the 26 th week of pregnancy to 42 days after delivery.Methods A total of 180 parturients from March 2018 to December 2019 in Fujian Medical University Zhangpu Teaching Hospital were analyzed retrospectively.To observe the delivery outcome and pelvic floor function,parturients were randomly divided into the observation group(n=89)and control group(n=91).Pregnant women in the observation group received Kegel training from the 26 th week of pregnancy to 42 days after delivery,while pregnant women in the control group underwent normal prenatal care without knowledge education of kegel exercise.Results Non-perturition rate at late pregnancy(46.07%),vaginal delivery rate(97.75%),perineal integrity rate(28.74%),pelvic floor muscle tension score(Deep I 3.3±1.5;Shallow I 2.7±1.3;Deep II 3.6±1.4;Shallow II 3.4±1.5 scores)in the observation group were higher than those of the control group(23.08%,86.81%,15.19%,Deep I 2.4±1.7,Shallow II 1.6±1.2,Deep II 2.3±1.5,Shallow II 2.2±1.7 scores,P<0.05).Labor time(Laboring process I 430.9±41.7,II 45.9±1.4,III 5.8±1.5,Total 482.6±44.6 min),perineal lateral shear rate(13.79%),perineal tear severity(Perineal tear I 94.00%,II 4.00%),and the recovery time of pelvic floor function(25.8±1.7 d)in observation group were significantly lower than those of the control group(Laboring process I 547.6±52.5,II 54.6±1.2,III 7.9±1.7,Total 610.1±55.4 min;26.58%;Perineal tear I 71.74%,II 19.56%;36.5±1.9 d;P<0.05).There was no significant difference between the two groups in the midwifery rate,neonatal asphyxia rate,postpartum hemorrhage rate and urinary retention rate(9.20%vs.12.66%;1.12%vs.5.49%;1.12%vs.4.40%;1.12%vs.6.59%;P>0.05).Conclusion Kegel exercise from the 26 th week of pregnancy to 42 days after delivery can significantly improve the delivery outcome and pelvic floor function of parturients.