枕位管理对产妇产程进展及分娩结局的影响

Effect of pillow position management on the progress of labor and delivery outcome

目的探究枕位管理对产妇产程进展及分娩结局的影响。方法选取2018年9月—2019年9月北京天坛医院待产孕妇110例作为研究对象,根据B超胎位检查的不同分为观察组(胎头位置异常)、对照组(胎头位置正常)两组,每组55例。对照组产妇分娩过程中采用常规护理,观察组在对照组的基础上结合枕位管理。比较两组产妇具体产程表现以及分娩结局。结果两组产妇年龄、孕周、体质量、身高以及Bishop评分等一般资料无明显差异。观察组产妇第一产程、第二产程以及总产程相较对照组产妇明显更短,差异具有统计学意义(P<0.05);两组产妇第三产程无明显差异。观察组产妇剖宫产5例(9.09%)、自然分娩46例(83.64%)、胎吸助产4例(7.27%),对照组剖宫产16例(20.09%)、自然分娩29例(52.73%)、胎吸助产10例(18.18%),观察组产妇剖宫产率明显低于对照组,自然分娩率明显高于对照组,差异具有统计学意义(P<0.05);观察组产妇产后出血量明显少于对照组(P<0.05);两组产妇产后出血率、产褥病率无明显差异。观察组新生儿窒息率明显低于对照组,差异具有统计学意义(P<0.05);两组新生儿窘迫率、Apgar评分无明显差异。结论枕位管理的重点内容是通过物理方法在产妇临产的一段时间内保证胎儿持续前移与背部前旋;在产妇第一产程、第二产程进行枕位管理,对胎儿保持枕前位有利,产妇总体分娩过程顺利,分娩结局良好。

Objective To explore the effect of pillow position management on the progress of labor and delivery outcomes.Methods A total of 110 pregnant women in our hospital from September 2018 to September 2019 were selected.They were divided into an observation group(abnormal fetal head position) and a control group(normal fetal head position) according to the B-ultrasound examination.Group 55 cases.The control group used routine nursing during delivery,and the observation group combined with pillow management on the basis of the control group.Compare the specific labor performance and delivery outcomes of the two groups of women.Results There were no significant differences in general data such as maternal age,gestational age,weight,height and Bishop score between the two groups,and they were not statistically significant.Compared with the control group,the first part,second part and total part of labor in the observation group were significantly shorter than those in the control group(P<0.05);there was no significant difference in the third part of the labor between the two groups.Not statistically significant.There were 5 cases of cesarean section in the observation group(9.09%),46 cases of natural delivery(83.64%),4 cases of fetal delivery(7.27%),16 cases of cesarean section(20.09%) in the control group,and 29 cases of natural delivery(52.73%),10 cases of fetal suction midwifery(18.18%),the cesarean delivery rate of the observation group was significantly lower than the control group,and the natural delivery rate was significantly higher than the control group,the difference w as statistically significant(P<0.05);the observation group The amount of postpartum hemorrhage was significantly lower than that of the control group(P<0.05);there was no significant difference in the postpartum hemorrhage rate and puerperal disease rate between the two groups,and there was no statistical significance(P>0.05).The neonatal asphyxia rate in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05);there was no significant difference in the neonatal distress rate and Apgar score between the two groups.Conclusion The key content of occipital position management is to ensure the continuous advancement of the fetus and the back rotation of the fetus through the physical method during the period of labor;the occipital position management in the first and second stages of labor of the mother is beneficial for the fetus to maintain the front position of the pillow.The overall delivery process of the mothers was smooth and the delivery outcome was good.