初产妇自由体位联合导乐陪伴分娩的观察  

Clinical observation on the outcomes of free position delivery with labor doula in primiparae

作　　者：曹文霞 李书勤 CAO Wenxia;LI Shuqin(Department of Obstetrics&Gynecology,The Second Affiliated Hospital of Wannan Medical College,Wuhu 241000,China)

机构地区：[1]皖南医学院第二附属医院妇产科,安徽芜湖241000 [2]皖南医学院第一附属医院弋矶山医院妇产科,安徽芜湖241001

出　　处：《皖南医学院学报》2021年第3期250-252,共3页Journal of Wannan Medical College

基　　金：安徽高校自然科学研究项目(KJ2015A142);皖南医学院第二附属医院三新项目(Y19052)。

摘　　要：目的:探讨初产妇分娩中应用自由体位联合导乐陪伴的临床效果。方法:选择皖南医学院第二附属医院产科2019年8月~2020年5月收治的足月待产初产妇120例作为研究对象,采用随机数字表法分为常规组(常规助产方式)和联合组(自由体位联合导乐陪伴助产方式)各60例。对比两组自然分娩率、宫缩时宫腔压力、产程时间、产后出血率、新生儿窒息和分娩满意度等指标。结果:(1)联合组自然分娩率(96.7%)高于常规组(80.0%),P<0.05;联合组产后出血发生率(1.6%)低于常规组(13.3%),P<0.05。(2)联合组新生儿窒息(0例)低于常规组(7例),P<0.05。(3)联合组产妇宫口开3 cm后宫缩时宫腔压力高于常规组;联合组第一产程和第二产程时间均低于常规组(P<0.05)。(4)联合组分娩满意度(98.3%)高于常规组(83.3%),P<0.05。结论:自由体位联合导乐陪伴分娩不仅能增加自然分娩率、宫缩时宫腔压力,缩短产程,而且能降低产后出血和新生儿窒息率,提高初产妇的分娩满意度。Objective:To observe the clinical effect of free position delivery with doula service in primiparae.Methods:One hundred and twenty full-term primiparae admitted to the second affiliated hospital of Wannan Medical College between August 2019 and May 2020 were included,and allocated to conventional delivery group(midwifed by conventional delivery,n=60)and combined delivery group(free position labor with doula service,n=60)by random digital table.The two groups were compared regarding natural delivery rate,uterine pressure during contraction,length of labor process,incidence of postpartum hemorrhage rate and neonatal asphyxia as well as patient′s satisfaction with the delivery.Results:(1)Natural delivery rate was higher,yet incidence of neonatal asphyxia was lower in combined delivery group than in conventional delivery group(96.7%and 80.0%vs.1.6%and 13.3%,respectively)(both P<0.05).(2)Neonatal asphyxia was zero in the combined delivery group,and occurred in 7 cases(11.6%)in the conventional delivery group.The difference was significant(P<0.05).(3)Patients in combined delivery group had higher uterine pressure at contraction by cervix dilating to 3 cm,and shorter labor process at stage 1 and 2 than those of the conventional delivery group(both P<0.05).(4)The satisfaction with delivery was higher in mothers in combined delivery group than in conventional delivery group(98.3%vs.83.3%)(P<0.05).Conclusion:Free position delivery with doula service can not only increase natural delivery rate,uterine pressure at contraction,shorten labor process,but also significantly reduce incidence of postpartum hemorrhage and neonatal asphyxia as well as improve primipara′s satisfaction with childbirth.

关 键 词：自由体位分娩 导乐式分娩 宫腔压力 新生儿窒息 产后出血 

分 类 号：R714.3[医药卫生—妇产科学]