助产士主导的分娩疼痛管理对初产妇阴道分娩疼痛及分娩结局的影响

Effect of Midwife-Led Labor Pain Management on Primipara’s Vaginal Delivery Pain and Delivery Outcome

目的探讨助产士主导的分娩疼痛管理对初产妇阴道分娩疼痛及分娩结局的影响。方法选择2020年1—12月沭阳县妇幼保健院接受助产士主导的分娩疼痛管理的53例初产妇作为观察组,2019年1—12月接受常规助产的53例初产妇作为对照组,采用视觉模拟评分量表(VAS)对产妇进行疼痛评分,观察时点选择活跃期、加速期、最大加速期、减速期。比较两组产妇分娩结局(产后24 h出血量、新生儿Apgar评分、产程延长率、剖宫产率)。结果观察组分娩活跃期、加速期、最大加速期、减速期VAS均低于对照组(P<0.05);观察组24 h出血量少于对照组(P<0.05);产程延长率低于对照组(P<0.05);剖宫产率低于对照组(P<0.05);新生儿Apgar评分高于对照组(P<0.05)。结论助产士主导的分娩疼痛管理可以减轻初产妇阴道分娩疼痛,减少24 h出血量,降低产程延长率与剖宫产率,提高新生儿Apgar评分。

Objective To explore the effect of midwife-led labor pain management on primipara’s vaginal delivery pain and delivery outcome.Methods A total of 53 primiparas who received midwife-led delivery pain management from January to December 2020 in Shuyang County Maternity and Child Health Hospital were selected as the observation group,and 53 primiparas who received routine midwifery from January to December 2019 served as the control group.Visual analogue scale(VAS)was used to score the pain of the puerpera,and the observation time points were active labor period,acceleration period,maximum acceleration period and deceleration period.The birth outcomes of primiparas(24 h bleeding volume,neonatal Apgar score,prolonged labor rate,cesarean section rate)were compared between the two groups.Results The VAS in the observation group during active labor period,acceleration period,maximum acceleration period,and deceleration period were lower than that of the control group(P<0.05).The 24 h bleeding volume of the observation group was less than that of the control group(P<0.05).The prolonged labor rate was lower than that of the control group(P<0.05).The cesarean section rate was lower than that of the control group(P<0.05).The Apgar score of newborns was higher than that of the control group(P<0.05).Conclusion Midwife-led labor pain management can reduce the pain of vaginal delivery of primiparas,reduce the 24 h bleeding volume,reduce the prolonged labor rate and cesarean section rate,and improve the Apgar score of newborns.