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目的探讨足月头位未衔接胎膜早破的初产妇临产前取自由体位的安全性与可行性。方法经过评估的未临产足月头先露未衔接的胎膜早破初产妇230例,采用随机法分为两组,实验组102例,入院完成检查后送待产室进行体位管理,对照组128例按照常规护理要求绝对卧床直至分娩。比较两组的脐带脱垂及新生儿窒息的发生情况、婴儿体重、分娩方式,排尿情况、产程时间、破膜距离分娩时间、干预前后胎头位置等指标。结果 (1)两组均无显性及隐性脐带脱垂发生,两组婴儿体重比较差异无统计学意义(P>0.05);(2)实验组阴道分娩率高于对照组(P<0.05),枕横位及枕后位的发生率低于对照组(P<0.01);(3)实验组产程时间、破膜距离分娩时间短于对照组,差异有统计学意义(P<0.01,P<0.01);(4)实验组干预2.5 h后的胎头位置明显下降,差异有统计学意义(P<0.01)。结论无头盆不称的足月、头位未衔接胎膜早破孕妇临产前经过干预后取自由体位可以提高自然分娩率,缩短产程。
Objective To investigate the safety and feasibility of primiparous women with uncapped premature rupture of membranes in preterm delivery. Methods 230 untreated preterm premature rupture of primiparous women who were not exposed for the first month after operation were divided into two groups according to randomization method. 102 cases in the experimental group were admitted to the delivery room for postural examination, while the control group 128 In accordance with the requirements of routine care absolute bed until childbirth. The incidence of umbilical cord prolapse and neonatal asphyxia, infant’s weight, mode of delivery, micturition, labor time, rupture distance of childbirth and fetal head position before and after intervention were compared between the two groups. Results (1) There was no significant or recessive umbilical cord prolapse in both groups. There was no significant difference in body weight between two groups (P> 0.05). (2) The vaginal delivery rate in the experimental group was higher than that in the control group ), And the incidence of occiput transverse position and posterior occiput posterior position was lower than that of the control group (P <0.01). (3) The labor time and rupture distance of the experimental group were shorter than that of the control group (P <0.01, P <0.01). (4) The position of fetal head decreased obviously in experimental group after 2.5 h intervention (P <0.01). Conclusions The full-term headache with unexplained headless head and the uncorrected head-end premature rupture of the pregnant woman can improve the rate of natural childbirth and shorten the labor process.