无痛分娩联合导乐仪在瘢痕子宫产妇剖宫产后阴道分娩中的应用效果

Application effect of painless delivery combined with Doula instrument in scar uterus puerpera undergoing vaginal birth after cesarean

目的研究无痛分娩联合导乐仪在瘢痕子宫产妇剖宫产后阴道分娩(VBAC)中的应用效果。方法选取我院2019年1月至2020年1月收治的300例瘢痕子宫产妇作为研究对象,按照分娩方式将其分为观察组(无痛分娩联合导乐仪)和对照组(无痛分娩),各150例。比较两组的分娩情况。结果观察组的阴道分娩率、有效镇痛率显著高于对照组(P<0.05)。麻醉10 min、1 h、2 h,两组的VAS评分均下降,且观察组低于对照组(P<0.05)。观察组的各产程时间均短于对照组,各产程用药量均少于对照组(P<0.05)。观察组的新生儿不良情况总发生率显著低于对照组(P<0.05);观察组胎儿出生5 min Apgar评分显著高于对照组(P<0.05)。结论导乐仪联合无痛分娩能有效提高阴道分娩率,降低产妇疼痛度,缩短产程用时,改善母婴结局,值得临床推广和应用。

Objective To study the application effect of painless delivery combined with Doula instrument in scar uterus puerpera undergong vaginal birth after cesarean(VBAC).Methods A total of 300 cases of scar uterus puerpera treated in our hospital from January 2019 to January 2020 were selected as the research objects and divided into observation group(painless delivery combined with Doula instrument)and control group(painless delivery)according to the mode of delivery,with 150 cases in each group.The delivery conditions of the two groups were compared.Results The vaginal delivery rate and effective analgesia rate of the observation group were significantly higher than those of the control group(P<0.05).After anesthesia for 10 min,1 h and 2 h,the VAS scores of the two groups decreased,and those in the observation group were lower than the control group(P<0.05).The time of each stage of labor in the observation group were shorter than those in the control group,and the drug consumption in each stage of labor were less than those in the control group(P<0.05).The total incidence of neonatal adverse events in the observation group was significantly lower than that in the control group(P<0.05);the Apgar score at 5 min of birth of fetus in the observation group was significantly higher than that in the control group(P<0.05).Conclusion Doula instrument combined with painless delivery can effectively improve vaginal delivery rate,reduce maternal pain degree,shorten labor time and improve maternal and infant outcomes,which is worthy of clinical promotion and application.