无医疗干预初产妇自然分娩的妊娠结局分析

目的:探讨无医疗干预初产妇自然分娩的妊娠结局。方法:将2013年1月至2014年12月在山东大学齐鲁医院住院分娩的3000例初产妇根据有无产程干预分为观察组和对照组,观察组1500例孕妇自然分娩,第一产程自由活动、饮食、休息,第二产程自主用力、自由体位分娩、无会阴保护、自然娩肩,第三产程延迟断脐、胎盘自然娩出;对照组1500例孕妇给予不同程度的医疗干预。比较两组孕妇的最终分娩方式及母儿结局。结果:观察组的自然分娩率、会阴完整率、新生儿评分高于对照组,而会阴切开率、会阴二度裂伤率、剖宫产率、产后出血量、羊水污染率明显低于对照组,差异有统计学意义(P0.05)。两组孕妇的孕周、总产程、新生儿出生体重、新生儿入住NICU率、羊水量、脐带绕颈等方面比较,差异无统计学意义(P0.05)。结论:对于低危初产妇,减少医疗干预,促进自然分娩,可获得较好的母儿结局。

The natural delivery outcome of primipara without interventions

Objective:To explore the natural delivery outcome of primipara without medical interventions. Methods:3000 primipara who had delivery in Qilu Hospital of Shandong University from Jan. 2013 to Dec. 2014 were divided into two groups according to the delivery approach:observing group,1500 cases without medical intervention, who had free activities, food,rest in the first labor stage and independent labor force,free position without perineal pro-tection delivery,waiting for shouders natural delivery in the second stage and delayed umbilical cord clamping after pulsation loss,natural delivery of placenta in the third stage;other 1500 ca-ses with different medical interventions were taken as control group. Mode of delivery and preg-nancy outcomes were compared between the two groups. Results:The natural delivery rate,in-tact perineum rate and apgar score at the 1 st min after birth were higher in the observing group than that in the control group. The episiotomy rate,perineal second degree laceration rate,cesar-ean section rate,postpartum bleeding,amniotic fluid pollution rate in the observing group were lower than that in control group(P<0. 05). There were no significant differences in gestational weeks,total labor stage,amnitic fluid volume,neonatal weight and the number of newborn trans-ferred to NICU between the two group(P>0. 05). Conclusions:For low-risk primipara,we can gain better outcome of pregnancy by reducing medical intervention and promoting natural deliv-ery.