气囊仿生助产术对二次妊娠合并瘢痕子宫高龄产妇阴道分娩产程和分娩结果的影响

目的 探讨气囊仿生助产术对二次妊娠合并瘢痕子宫高龄产妇阴道分娩产程和分娩结果的影响.方法 选取惠州市第三人民医院2014年5月至2017年5月收治的80例二次妊娠合并瘢痕子宫高龄产妇作为研究对象,均具有阴道试产条件,且不符合剖宫产指征,按随机数字表法分为对照组和观察组,各40例.观察组待产妇宫口开大至3 cm,胎先露下降至-1以下进入产房后采取气囊仿生助产术;对照组产妇选择常规阴道分娩.记录两组对象的产程时间、出血情况、新生儿情况和分娩结局.结果观察组产妇第一、二产程以及总产程的平均时间分别为(6.35±1.66)h、(0.76±0.13)h和(6.51±2.20)h,均短于对照组的(11.27±2.14)h、(1.35±0.21)h和(10.37±2.61)h,差异均有统计学意义(P<0.05).观察组的产时和产后2 h出血量分别为(111.97±23.84)mL和(234.13±59.03)mL,均少于对照组的(123.24±26.30)mL和(264.65±57.26)mL,差异均有统计学意义(P<0.05).两组新生儿Apgar评分和窒息情况比较,差异无统计学意义(P>0.05).对照组胎儿窘迫的例数多于观察组,差异有统计学意义(P<0.05).两组产钳助产例数差异无统计学意义(P>0.05),自然分娩和剖宫产例数差异有统计学意义(P<0.05).结论 气囊仿生助产在二次妊娠合并瘢痕子宫高龄产妇阴道分娩中具有明显优势,可有效缩短产程,减少子宫出血和胎儿窘迫的发生,并提高自然分娩的成功率,改善分娩结局.

Influence of bionic air-bag midwifery on delivery process and consequence of vaginal delivery in elderly parturient women with second pregnancy combined with cicatricial uterus

Objective To explore the influence of bionic air -bag midwifery on delivery process and consequence of vaginal delivery in elderly parturient women with second pregnancy combined with cicatricial uterus .Methods We selected 80 cases of elderly parturient women with second pregnancy combined with cicatricial uterusas the research objects in our hospital from May 2014 to May 2017 .These women who had vaginal trial and did not conform caesarean indication were randomly divided into control group and experimental group , with 40 cases in each group .Experimental group were sent into delivery roomwhen the cervix opened to 3 cm and fetal presentation descended below -1. The control group chose routine vaginal delivery .We recorded the duration of production , bleeding, neonatal condition and outcome of child-birth.Results Theaverage time of first, second, and total delivery process in experimental group was (6.35 ±1.66)h, (0.76 ±0.13)h and (6.51 ±2.20)h, respectively, which was obviouslyshorter than that in control group , which was(11.27 ±2.14)h, (1.35 ±0.21)h and (10.37 ±2.61)h, respectively, with significant difference(t=-11.490,15.108,7.152, P<0.001).The blood loss in birth time and postpartum two hours of experimental group was (111.97 ±23.84)mL and (234.13 ±59.03)mL, respectively, which were less than that of control group, which was (123.24 ±26.30)mL and (264.65 ±57.26)mL, respectively, with significant difference(t=-2.008,2.347, P<0.05).The Apgar score and asphyxia of two groups had no significantdifference (t=0.359, P=0.721;χ2 =0.513, P=0.474).Cases of fetal distress in control group were more than those in experimental group ,with significant difference (χ2 =4.804, P=0.028).Cases of forceps delivery in two groups had no significant difference (χ2 =1.385, P=0.239).Cases of vaginal delivery and caesarean had significant difference(χ2 =8.067,4.781, P=0.005,0.029).Conclusion Bionic air -bag midwifery has obvious superiority in vaginal delivery of elderly parturient women with second pregnancy combined with cicatricial uterus .It can effectively shorten delivery process and reduce uterine bleeding and fetal distress , and improve the success rate of vaginal delivery and the consequence of childbirth .