自由体位干预在无痛分娩中的应用及对母婴结局的影响

Application of Free Position Intervention in Painless Delivery and its Influences on Maternal and Neonatal Outcomes

目的探讨自由体位干预在无痛分娩中的应用及对母婴结局的影响。方法回顾性选取2019年10月-2021年4月于广东省阳江市妇幼保健院进行分娩的120例产妇,根据分娩体位不同分为对照组和观察组,各60例。对照组采用传统体位无痛分娩,观察组采用自由体位无痛分娩,观察两组产妇的总产程时间及最终分娩方式。观察两组产妇发生产后出血、会阴侧切、会阴水肿及宫颈裂伤情况。采用疼痛视觉模拟评分量表(VAS)、爱丁堡产后抑郁量表(EPDS)分别评估两组产妇分娩时自感疼痛程度及产后心理状态;采用新生儿Apgar量表评估新生儿窒息情况。结果观察组总产程时间明显短于对照组(P<0.05)。观察组产程中转剖宫产发生率、阴道助产率、产妇产后出血、会阴侧切、会阴水肿及宫颈裂伤发生率均显著低于对照组(P<0.05)。观察组产妇分娩过程中VAS及产后EPDS评分均明显优于对照组(P<0.05)。观察组新生儿Apgar量表评分高于对照组,差异具有统计学意义(P<0.05)。结论自由体位干预应用于无痛分娩中可缩短产程,降低转剖宫产、阴道助产发生率,减轻疼痛且缓解抑郁,有效改善母婴结局。

Objective To explore the application of free position intervention in painless delivery and its influences on maternal and neonatal outcomes.Methods A retrospective selection was performed on the 120 puerperae undergoing delivery in obstetrics department of the hospital between October 2019 and April 2021.According to different delivery positions,they were divided into control group and observation group,60 cases in each group.The control group was given traditional position,while observation group was given free position for painless delivery.The total labor time,final delivery modes and the occurrence of postpartum hemorrhage,perineotomy,perineal edema and cervical laceration in both groups were observed.The self-perceived pain at delivery and postpartum psychological state in both groups were evaluated by Visual Analogue Scale(VAS)and Edinburgh Postpartum Depression Scale(EPDS).The neonatal asphyxia was assessed by neonatal Apgar scale.Results The total labor time in observation group was significantly shorter than that in control group(P<0.05),incidence of transition to cesarean section,vaginal delivery,postpartum hemorrhage,perineotomy,perineal edema and cervical laceration was significantly lower than that in control group(P<0.05),scores of VAS during delivery and postpartum EPDS were significantly better than those in control group(P<0.05),and score of neonatal Apgar scale was higher than that in control group(P<0.05).Conclusion The application of free position intervention in painless delivery can shorten labor stage,reduce the incidence of transition to cesarean section and vaginal delivery,relieve pain and depression,and effectively improve maternal and neonatal outcomes.