自由体位对分娩影响的临床观察  

Clinical observation on effect of free position on delivery

作　　者：覃秀珠[1] 沈岩金[1] 

机构地区：[1]广西中医药大学第一附属医院产科,广西南宁530023

出　　处：《中国妇幼保健》2014年第12期1842-1844,共3页Maternal and Child Health Care of China

摘　　要：目的：探讨自由体位对分娩结局的影响。方法：将2012年3月～9月住院分娩的足月妊娠、单胎头位、未破膜，有阴道试产条件的自然临产初产妇400例，随机分为两组：观察组和对照组，观察组进入第一产程后取自由体位，对照组取平卧或侧卧位，观察组宫口开全会阴膨隆、阴裂分开，胎头S＋3后上产床，对照组宫口开全后上产床。两组常规取半卧膀胱截石位分娩。分别统计两组阴道分娩第一产程、第二产程、第三产程、总产程时间，两组剖宫产率、阴道助产率，两组产后出血发生率和新生儿窒息发生率。结果：两组阴道分娩第一产程、第二产程、总产程时间差异有统计学意义（P值均〈0．01）；两组剖宫产率、阴道助产率、新生儿窒息发生率差异有统计学意义（P值均〈0．05）。结论：自由体位分娩可明显缩短第一产程、第二产程、总产程时间，降低剖宫产率、阴道助产率，降低新生儿窒息发生率。Objective： To explore the effect of free position on delivery outcome. Methods： A total of 400 primiparous women （full -term pregnancy, single pregnancy, head position, without rupture of membranes, trial of vaginal labor） were selected from the hospi- tal from March to September in 2012, and then they were randomly divided into observation group and control group： the primiparous women in observation group entered the first stage of labor after taking free position, while the primiparous women in control group took supine or lat- eral decubitus. The primiparous women in observation group started delivery after cervix open, perineum distention, vulval slit apart, and fe- tal head S ＋3 ; while the primiparous women in control group started delivery after cervix open. The primiparous women in the two groups a- dopted semireclining lithotomy position. The duration times of the first stage of labor, the second stage of labor, the third stage of labor and the total stage of labor, cesarean section rates, vaginal delivery rates, incidence rates of postpartum hemorrhage and neonatal asphyxia in the two groups were compared respectively. Results： There were statistically significant differences in the duration times of the first stage of la- bor, the second stage of labor and the total stage of labor between the two groups （ P 〈 0. 01 ） ; there were statistically significant differences in cesarean section rate, vaginal delivery rate and incidence rate of neonatal asphyxia between the two groups （ P 〈 0. 05 ） . Conclusion ： Free position childbirth can shorten the duration times of the first stage of labor, the second stage of labor and the total stage of labor, reduce cesarean section rate, vaginal delivery rate and incidence rate of neonatal asphyxia.

关 键 词：体位 分娩 观察 

分 类 号：R714[医药卫生—妇产科学]