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目的探讨不同待产体位对足月头位已衔接的胎膜早破孕妇阴道分娩结局的影响。方法选取2013年1月-2014年1月间在该院住院拟行阴道试产的胎膜早破孕妇116例,随机分为观察组和对照组,每组各58例。观察组孕妇取自由体位至宫口全开,对照组孕妇全程取平卧位或侧卧臀高位至宫口全开。对比两组孕妇的阴道分娩结局。结果两组孕妇均未出现脐带脱垂;观察组孕妇阴道分娩率(70.69%)明显高于对照组(46.55%),差异有统计学意义(χ~2=6.831,P<0.01)。观察组孕妇第一产程时间[(8.52±21.06)min]和第二产程时间[(49.82±16.47)min]均明显短于对照组[(10.46±33.70)min、(92.51±30.14)min],产前流出羊水量[(118.27±27.19)ml]明显少于对照组[(259.42±44.76)ml],差异均有统计学意义(t值分别为2.228、2.866和4.299,均P<0.05)。两组孕妇产后出血量、新生儿体重、新生儿Apgar评分之间比较差异均无统计学意义(t值分别为0.051、0.374和0.043,均P>0.05)。观察组孕妇尿潴留发生率(1.72%)明显低于对照组(12.07%),差异有统计学意义(χ~2=8.224,P<0.01);两组孕妇导尿次数,新生儿窒息、产褥感染、粪便感染发生率之间差异均无统计学意义(χ~2值分别为0.296、0.961、0.237和0.986,均P>0.05)。结论足月头位已衔接的胎膜早破孕妇取自由体位可提升阴道分娩率并可缩短产程,减少产程中羊水流出量和产妇排尿困难的发生率,提升产妇分娩舒适度且具有较好的安全性,值得临床推广应用。
Objective To investigate the effect of different birth positions on the outcomes of vaginal delivery in pregnant women with premature rupture of membranes. Methods One hundred and sixteen pregnant women with premature rupture of membranes who were hospitalized in this hospital from January 2013 to January 2014 were randomly divided into observation group and control group with 58 cases in each group. Observation group of pregnant women taken from the position to the cervix full open, the control group of pregnant women to take full position or lateral hip position to full open cervix. Contrast two groups of pregnant women vaginal delivery outcomes. Results No umbilical cord prolapse occurred in the two groups of pregnant women. The vaginal delivery rate (70.69%) in the observation group was significantly higher than that in the control group (46.55%) (χ ~ 2 = 6.831, P <0.01). The duration of the first stage of labor in the observation group was significantly shorter than that in the control group [(8.52 ± 21.06) min and the second stage of labor [(49.82 ± 16.47) min, [(10.46 ± 33.70) min, (92.51 ± 30.14) min) Prenatal outflow of amniotic fluid [(118.27 ± 27.19) ml] was significantly less than the control group [(259.42 ± 44.76) ml], the differences were statistically significant (t = 2.228,2.866 and 4.299, all P <0.05). There was no significant difference in postpartum hemorrhage, newborn weight and Apgar score between the two groups (t = 0.051,0.374 and 0.043, all P> 0.05). The incidence of urinary retention in the observation group was significantly lower than that in the control group (1.72% vs 12.07%, χ ~ 2 = 8.224, P <0.01). The frequency of catheterization, neonatal asphyxia, There was no significant difference between the incidences of puerperal infection and stool infection (χ ~ 2 values were 0.296,0.961,0.237 and 0.986, all P> 0.05). Conclusions The premature rupture of membranes of full-term head position pregnant women taking free position can improve the vaginal delivery rate and shorten the labor process, reduce the amniotic fluid outflow in labor and the incidence of maternal dysuria, improve maternal labor comfort and have better Safety, it is worth promoting clinical application.