心理状况变化对孕产妇分娩方式的影响

目的探讨孕产妇的心理状况随孕周进展的动态变化对其分娩方式的影响,寻求降低剖宫产率的有效对策。方法采用自制问卷、症状自评量表(scL-90)、总体幸福感量表,对106例孕产妇分别于孕35周、38周、产后72h进行心理状况的评定分析。结果106例孕产妇中自然分娩57例,占53.77%;剖宫产49例,占46.23%(其中无产科指征14例,占28.57%)。无指征剖宫产组分娩前后焦虑、恐怖、抑郁因子分均高于自然分娩及有指征剖宫产组,抑郁因子分均高于自然分娩组及有指征剖宫产组,差异有统计学意义(P<0.001)。相关分析表明:幸福感、对生育的期望、文化程度与孕产妇的症状水平呈显著负相关(P<0.01),分娩方式与孕产妇心理状况呈显著正相关(P<0.01)。结论无产科指征的剖宫产主要是与随孕周进展乃至分娩而渐进的焦虑、恐怖、抑郁有关。因此,有针对性的进行心理干预可望降低剖宫产率。

Changes of psychological state plays the role in the mode of delivery in pregnant women

Objective To investigate the dynamic changes of psychological states and the mode of delivery in pregnant women,simultaneously,study the effective way to reduce the rate of cesarean section.Methods Through applying the self-compiled test paper,the self-evaluating state table(SCL-90)and the table of overall feeling of happiness,we assessed the psychological states of 106 pregnant women.The results were recorded at 35 and 38 weeks of gestation and 72 hours postpartum.Results 57 delivered vaginally(53.77%).49 were managed by cesarean section(46.23%),including 14 non-indicated cesarean section(28.57%).The mark of anxiety,terror and depression factors increased in the group of non-indicated cesarean section before and after delivery compared with the group of vaginal delivery and indicated cesarean section.There was remarkable difference(P<0.01).The value of overall feeling of happiness in the group of non-indicated cesarean section was less than that in the group of vaginal delivery.The difference was extremely significant(P<0.001).The relevant analysis showed that the feeling of happiness,the desire of labor and educational level were related negatively to the level of symptom during pregnancy(P<0.001).The mode of delivery was related positively to the psychological state of pregnant women(P<0.01).Conclusion Non-indicated cesarean section is mainly interrelated to anxiety,terror and depression that proceed gradually during pregnancy and delivery.So it is suggested that the aimed psychological education be beneficial to decrease the rate of cesarean section.