助产士主导下无创分娩干预对产程、会阴侧切、分娩结局影响  

Effects of midwife-led non-invasive delivery intervention mode of pregnant women on their labor duration,episiotomy rate,and delivery outcomes

作　　者：唐文凤 吴文芳[1] 周翠英[1] TANG Wenfeng;WU Wenfang;ZHOU Cuiying(General Hospital of Wanbei Coal and Electricity Group,Suzhou Anhui Province,234000)

机构地区：[1]皖北煤电集团总医院,宿州234000

出　　处：《中国计划生育学杂志》2023年第5期1121-1125,共5页Chinese Journal of Family Planning

摘　　要：目的:探究助产士为主导的无创分娩干预模式应用对其产程、会阴侧切率、分娩结局的影响。方法:选取2021年10月-2022年12月本院接收的孕妇92例,随机分为助产无创、传统组各46例,对比两组产程、会阴侧切率、会阴撕裂程度、疼痛评分、分娩结局,多因素logistic回归分析新生儿窒息影响因素。结果:助产组第一产程、第二产程、第三产程均缩短,会阴撕裂率(40.0%)与会阴侧切率(15.2%)均低于传统组(58.7%、40.0%),产后疼痛评分低于传统组,新生儿Apgar评分(7.22±2.21分)与窒息发生率(13.0%)均低于传统组(5.53±1.43分、41.3%)(均P<0.05)。产妇年龄≥30岁、产程异常、合并妊娠期糖尿病是新生儿窒息发生独立危险因素(P<0.05)。结论:助产士主导下无创分娩干预模式可以缩减产程并降低会阴侧切率,减轻会阴撕裂损伤与疼痛感,有助于改善分娩结局;针对新生儿窒息发生的危险因素,可作为后续新生儿窒息的重点预防方向。Objective:To explore the effects of midwife-led non-invasive delivery intervention mode of pregnant women on their labor duration,episiotomy rate,and delivery outcomes.Methods:A total of 92 pregnant women were selected and were randomly divided into two groups(46 cases in each group)from October 2021 to December 2022.The women in study group were given midwife-led non-invasive delivery intervention,and the women in control group were given traditional delivery intervention.The labor duration,the episiotomy rate,the degree of perineal tear,the pain score,and the delivery outcomes of the women were compared between the two groups.Multivariate Logistic regression was used to analyze the influencing factors of neonatal asphyxia of the women in the two groups.Results:The duration of the first,second,and third stages of labor of the women in the study group had shortened significantly.The rates of perineal tear(40.0%)and lateral perineal incision(15.2%)of the women in the study group were significantly lower than those(58.7%and 40.0%)of the women in the control group,and the postpartum pain score of the women in the study group was significantly lower.The neonatal Apgar score(7.22±2.21 points)and the incidence of asphyxia(13.0%)in the study group were significantly lower than those(5.53±1.43 points and 41.3%)in control group(all P<0.05).Maternal age≥30 years old,the abnormal labor,and the gestational diabetes mellitus were the independent risk factors of asphyxia(P<<0.05).Conclusion:The application of midwife-led non-invasive delivery intervention mode of the women can reduce their labor process and the rate of episiotomy,and relieve the perineal tear injury and pain,which is helpful to improve the delivery outcomes of women.The risk factors of the neonatal asphyxia can be used as the key prevention direction of neonatal asphyxia in the future.

关 键 词：无创助产分娩 产程 会阴侧切 会阴撕裂 分娩结局 影响因素 

分 类 号：R473.71[医药卫生—护理学]