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目的:探讨产妇第二产程采用不同体位下自主用力分娩对母婴的临床效果。方法:将126例足月初产妇随机分为两组,观察组采用自由直立体位进行自主用力分娩,对照组采用平卧位下的自主用力分娩,比较两组的分娩结局。结果:观察组第二产程、自主用力时间、产后出血量均少于对照组(t=2.388,P=0.018;t=2.521,P=0.013;t=2.863,P=0.005);在发生胎儿宫内窘迫及新生儿窒息方面两组差异无统计学意义(P>0.05),在会阴侧切、宫颈水肿、会阴Ⅰ度裂伤方面对照组较观察组严重程度更高(χ2=8.355,P=0.004;χ2=9.657,P=0.002;χ2=7.569,P=0.006)。结论:足月初产妇在第二产程采取在自由直立体位下自主用力分娩的方式具有缩短第二产程、保护会阴等优点,可有效地提高产妇分娩质量。
Objective: To investigate the clinical effect of maternal second labor on maternal and infant through independent forced labor under different positions. Methods: 126 full-term primiparae were randomly divided into two groups. The observation group was given free forced birth with free standing position. The control group was given autonomous force delivery under supine position. The delivery outcomes of the two groups were compared. Results: The second stage of labor, voluntary exertion time and the amount of postpartum hemorrhage in the observation group were all less than those in the control group (t = 2.388, P = 0.018; t = 2.521, P = 0.013; There was no significant difference between the two groups in internal distress and neonatal asphyxia (P> 0.05). The severity of episiotomy, cervix edema and perineal first degree laceration were higher in the control group than in the observation group (χ2 = 8.355, P = 0.004 ; χ2 = 9.657, P = 0.002; χ2 = 7.569, P = 0.006). Conclusion: The full-term primipara leads to the shortest second stage of labor and the protection of the perineum in the second stage of labor in the mode of free exertion and forced labor. It can effectively improve the quality of maternal delivery.