二胎高龄孕妇心理状态评分对内心期望分娩方式的影响及其临床意义

目的探讨二胎高龄孕妇心理状态评分与其内心期望分娩方式的关系,分析内心期望分娩方式与实际分娩方式之间的异同对妊娠结局的影响。方法选取2017年1月至2018年6月在广西壮族自治区人民医院进行常规产检的312例二胎高龄孕妇为研究对象,收集一般资料与内心期望的分娩方式,采用焦虑自评量表(Self-Rating Anxiety Scale,SAS)与抑郁自评量表(Self-Rating Depression Scale,SDS)对患者心理状态进行评分,观察不同孕期孕妇心理状态、其内心期望的分娩方式以及分娩结局。结果孕晚期阶段,期望进行阴道生产的孕妇SAS、SDS评分均明显低于期望进行剖宫产的孕妇(P<0.05),心理状态不佳孕妇中期望进行剖宫产所占的比例明显高于心理状态良好者期望进行剖宫产的比例(P<0.05)。孕晚期期望分娩方式与最终分娩方式不一致的产妇产后抑郁与产后出血发生率显著高于一致组产妇,且新生儿Apgar评分也低于一致组,差异均有统计学意义(P<0.05)。结论二胎高龄孕妇的心理状态会影响孕妇内心的期望分娩方式,当实际分娩方式与预期分娩方式不一致时,会进一步增加孕产妇的负性情绪程度,从而影响妊娠结局,临床需引起重视,必要时给予相应的干预措施。

Effect of psychological status score of second-born pregnant women on inner expectation of delivery and its clinical significance

Objective To explore the relationship between the psychological status score of the second-born elderly women and their inner expectation of delivery,and analyze the impact of the similarities and differences between the inner expectation and actual delivery on pregnancy outcomes. Methods From January 2017 to June 2018,312 pregnant women with second trimester pregnancy who underwent routine checkups in the People’s Hospital of Guangxi Zhuang Autonomous Region were selected as the research subjects.General data and inner expectation of delivery were collected. Self-rating anxiety scale( SAS) and Self-rating depression scale( SDS)were used to score the psychological state of the patients,and to observe the psychological state of pregnant women at different stages of pregnancy,their inner childbirth expectation and delivery outcomes. Results In the third trimester,the SAS and SDS scores of pregnant women expecting vaginal delivery were significantly lower than those expecting cesarean delivery( P < 0. 05). The proportion of expectant cesarean delivery among pregnant women with poor mental status was obvious. It was higher than the proportion of those who were in good psychological state expecting cesarean section( P < 0. 05). The incidence of postpartum depression and postpartum hemorrhage in the second trimester of expectation and the final delivery were significantly higher than those in the same group,and the Apgar score of the newborn was lower than that in the same group,and the differences were statistically significant( P < 0. 05).Conclusion The psychological state of the second trimester of pregnancy can affect the expectant delivery mode of the pregnant woman. When the actual delivery mode is not consistent with the expected delivery mode,it will further increase the negative emotional level of the pregnant woman,which will affect the pregnancy outcome. Appropriate intervention measures should be given from time to time.