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目的:探讨孕期体重管理结合拉玛泽减痛分娩(简称减痛法)对妊娠结局的影响,为孕期母婴保健工作提供参考。方法:选取2012年6月~2013年6月间在该院产科检查并分娩且体重指数正常的孕妇420例,均行孕期体重管理,依据孕期体重增加情况以及是否进行减痛法练习分为四组:A组125例,孕28周起坚持进行减痛法练习且孕期体重增加11.5~16.0kg;B组135例,未进行减痛法练习且孕期体重增加11.5~16.0 kg;C组65例,孕28周起坚持进行减痛法练习且孕期体重增加>16.0 kg;D组95例,未进行减痛法练习且孕期体重增加>16.0 kg,比较四组母婴结局。结果:A组孕妇的剖宫产率明显低于D组,差异有统计学意义(P<0.05),A组孕妇的剖宫产率与B、C两组之间差异无统计学意义(P>0.05);A组产妇阴道分泌总产程时间明显短于另外三组,差异有统计学意义(P<0.05);A组孕妇Ⅰ度会阴损伤的发生率明显高于另外三组,会阴侧切率明显低于另外三组,差异均有统计学意义(P<0.05);A组孕妇产后出血率明显低于D组,差异有统计学意义(P<0.05);A组新生儿体重明显低于C组和D组,差异均有统计学意义(P<0.05);A组新生儿黄疸发生率明显低于D组,新生儿窒息发生率明显低于另外三组,差异均有统计学意义(P<0.05)。结论:在孕期体重管理良好的基础上联合减痛法,能够有效缩短产程,降低产后出血率,保护会阴,改善妊娠结局。
Objective: To explore the influence of pregnancy weight management combined with Lamaze pain relief (referred to as pain reduction method) on the pregnancy outcome, provide reference for maternal and infant health care during pregnancy. Methods: From June 2012 to June 2013, 420 pregnant women with normal body mass index and obstetric examination and obstetric examination during the period from June 2012 to June 2013 were enrolled in the study. Body weight management during pregnancy was divided into four groups according to the weight gain during pregnancy and the practice of reducing pain. Group A: Group A 125 cases, from 28 weeks pregnant insist on reducing pain practice and pregnancy weight gain 11.5 ~ 16.0kg; Group B 135 cases without pain reduction exercises and pregnancy weight gain 11.5 ~ 16.0 kg; C group 65 cases , 28 weeks of pregnancy adhere to the practice of pain reduction exercises and pregnancy weight gain> 16.0 kg; D group of 95 cases, without pain reduction exercise and pregnancy weight gain> 16.0 kg, compared four groups of maternal and infant outcomes. Results: The rate of cesarean section in pregnant women in group A was significantly lower than that in group D (P <0.05), while the rate of cesarean section in pregnant women in group A was not significantly different from those in groups B and C (P > 0.05). The time of vaginal secretion in group A was significantly shorter than that in the other three groups (P <0.05). The incidence of Ⅰ degree perineal injury in group A was significantly higher than that in the other three groups. The rate of episiotomy (P <0.05). The postpartum hemorrhage rate in pregnant women in group A was significantly lower than that in group D (P <0.05), and the weight of newborn in group A was significantly lower than that in group D (P <0.05). The incidence of neonatal jaundice in group A was significantly lower than that in group D, and the incidence of neonatal asphyxia was significantly lower than that in the other three groups (P <0.05). The difference was statistically significant (P < P <0.05). Conclusion: The combination of pain reduction method on the basis of good weight management during pregnancy can effectively shorten the labor process, reduce the rate of postpartum hemorrhage, protect the perineum and improve the pregnancy outcome.