导乐陪伴分娩联合自由体位分娩对产妇产道损伤的影响

Effects of doula⁃accompanied delivery combined with free posture delivery on maternal birth canal injury

目的探究导乐陪伴分娩联合自由体位分娩对产妇产道损伤的影响。方法选取2019年2月至2022年2月于南通市第六人民医院分娩的98例产妇作为研究对象,采用数字表法分随机为2组,每组各49例。观察组行导乐陪伴分娩联合自由体位分娩,对照组行自由体位分娩。比较产妇在不同分娩方式中的自我效能、疼痛程度及分娩期间的不良情绪,记录产妇产后分娩过程中出血量及总产程时间,比较2组产妇妊娠结局及产道损伤情况。结果观察组分娩自我效能量表(CB⁃SEI⁃32)评分、视觉模拟量表(VAS)评分均高于对照组(P<0.05)。与干预前比较,干预后2组产妇汉密尔顿焦虑量表(HAMA)评分及分娩态度量表(CAQ)评分均降低,观察组HAMA评分、CAQ评分低于对照组(P<0.05);观察组产后24 h内、产后出血量及总产程均低于对照组(P<0.05);观察组产妇自然分娩率、阴道分娩率均高于对照组(P<0.05),剖宫产率低于对照组(P<0.05);观察组产道损伤发生率为12.24%,低于对照组的28.57%(P<0.05)。结论导乐陪伴分娩联合自由体位分娩有利于帮助产妇在更加轻松舒适的环境下进行自然分娩,能够有效控制产妇产道损伤的发生。

Objective To explore the effects of doula⁃accompanied delivery combined with free posture delivery on maternal birth canal injury.Methods A total of 98 puerperae who gave birth in the hospital from February 2019 to February 2022 were enrolled for study and divided into the control group(n=49)and the observation group(n=49)according to the random number table method.The observation group received doula⁃accompanied delivery combined with free posture delivery,while the control group just received free posture delivery.The maternal self⁃efficacy,pain severity and bad mood during delivery were compared between different delivery modes.The amount of blood loss during and after delivery and the total labor time were recorded,and the pregnancy outcomes,the adverse maternal outcomes and maternal birth canal injury were compared between the two groups.Results The scores of delivery self⁃efficacy scale(CBSEI⁃32)and visual analog scale(VAS)CBSEI⁃C32 in the observation group were all higher than those in the control group(P<0.05).Compared with those before intervention,Hamilton anxiety scale(HAMA)scores and Childbirth attitude qestionnaire(CAQ)scores of the two groups all decreased after intervention,with the HAMA scores and CAS scores of the observation group being lower than those of the control group(P<0.05).Within 24 hours,the amount of postpartum blood loss and total labor time in the observation group were all lower than those in the control group(P<0.05).The rate of natural and vaginal delivery in the observation group was higher than that in the control group(P<0.05),while the rate of cesarean section was lower as compared with that in the control group(P<0.05).The rate of birth canal injury was 12.24%in the observation group,which was lower than 28.57%in the control group(P<0.05).Conclusion Doula⁃accompanied delivery combined with free posture enables the parturient to have natural delivery in a more relaxed and comfortable environment and could effectively control the occurrence of maternal birth canal injury.