改良四肢着床操作法对高龄初产妇妊娠结局和产后舒适度的影响  

The effect of the modified Gaskin maneuver on delivery outcomes and postpartum comfort in elderly primiparas

作　　者：胡愈芝 邹小玲[1] 谭红艳[1] HU Yuzhi;ZOU Xiaoling;TAN Hongyan(Department of Obstetrics,Chenzhou NO.1 People’s Hospital,Hunan,Chenzhou 423000,China)

机构地区：[1]湖南省郴州市第一人民医院产科,423000

出　　处：《河北医药》2023年第3期416-419,共4页Hebei Medical Journal

摘　　要：目的探讨改良四肢着床操作法对高龄初产妇妊娠结局和产后舒适度的影响。方法选取2019年4月至2021年10月在郴州市第一人民医院分娩的96例高龄初产妇作为研究对象,按照随机数字表法分为试验组和对照组,每组48例。试验组在第二产程采用改良四肢着床操作法,对照组采用屈膝半卧位。比较2组产妇妊娠结局和产后舒适度的差异。结果试验组全部自然分娩,对照组自然分娩39例,2组产妇分娩方式比较,差异有统计学意义(P<0.05)。试验组第二产程时长、产后2 h出血量少于对照组;试验组会阴侧切率、会阴裂伤程度低于对照组,差异有统计学意义(P<0.05)。产后24 h,试验组会阴肿胀程度优于对照组,会阴疼痛评分、产后疲乏量表得分低于对照组,差异有统计学意义(P<0.05)。结论改良四肢着床操作法可提高高龄初产妇自然分娩率,减少第二产程时长、降低会阴侧切率和产后出血量,提高产妇产后分娩舒适度。Objective To explore the effect of modified Gaskin maneuver(all fours position)on delivery outcomes and postpartum comfort in elderly primiparas.Methods From April 2019 to October 2021,a total of 96 elderly primiparas delivered at Chenzhou First people’s Hospital retrospectively recruited.They were randomly assigned to the experimental group and control group,with 48 cases in each group.The modified all fours position,and knee-bent semi-recumbent position were adopted in the second stage of labor were adopted in the treatment group and control group,respectively.Delivery outcomes and postpartum comfort between two groups were compared.Results Natural delivery was achieved in 48 and 39 cases of treatment group and control group,respectively.There was a significant difference in the delivery mode between the two groups(P<0.05).The duration of the second stage of labor and the amount of 2h postpartum hemorrhage in the experimental group were significantly less than those in the control group(P<0.05).The rate of lateral episiotomy and the degree of perineal laceration in the experimental group were significantly lower than those in the control group(P<0.05).At 24 hours postpartum,the degree of perineal swelling in the experimental group was significantly better than that in the control group,and the scores of perineal pain and postpartum fatigue were significantly lower than those in the control group(P<0.05).Conclusion The modified Gaskin maneuver(all fours position)can enhance the natural delivery rate,shorten the second stage of labor,reduce the rate of lateral episiotomy and postpartum hemorrhage,and improve the postpartum comfort in elderly primiparas.

关 键 词：改良分娩体位 初产妇 高龄 妊娠结局 舒适度 

分 类 号：R714.3[医药卫生—妇产科学]