侧卧位分娩对产程及母婴结局的影响

目的 比较侧卧位分娩与传统仰卧位分娩对产程以及母婴结局的影响.方法 选择2015年8月至2016年6月在西安交通大学医学院第一附属医院妇产科产房无合并症的足月初产妇200例为研究对象,其中100例侧卧位分娩为研究组,100例传统仰卧位分娩为对照组,比较两组产妇的第二产程时限、会阴损伤、新生儿窒息及产后出血等母儿结局.结果 研究组产妇第二产程显著短于对照组(t=-3.10,P<0.05).研究组胎儿窘迫、新生儿窒息发生率显著低于对照组(χ2值分别为6.37、5.10,均P<0.05),而两组新生儿锁骨骨折、新生儿臂丛神经损伤发生率无显著性差异(χ2值分别为2.75、1.01,均P>0.05).研究组的产妇会阴完整率明显优于对照组(χ2=7.29,P<0.01),且产后出血发生率显著低于对照组(χ2=4.35,P<0.05).结论 侧卧位分娩能够预防胎儿窘迫,减少新生儿窒息,减少产妇的会阴撕裂伤,降低产妇会阴侧切率,有利于产后恢复,还能够预防产后出血的发生,值得临床推广.

Effect of lateral position delivery on labor and outcomes of mother and fetus

Objective To compare the effect of lateral position delivery and supine position delivery on stage of labor and outcomes of mother and fetus.Methods From August 2015 to June 2016 a total of 200 full-term primiparas without complications were selected from the First Affiliated Hospital of Xi' an Jiaotong University in study, including 100 cases of lateral position in study group and 100 cases of supine position in control group.Two groups were compared in second stage of labor, perineum injury, neonatal asphyxia and postpartum hemorrhage.Results In the observation group, the second stage was significantly shorter than that in the control group ( t=-3.10, P<0.05).The incidence of fetal distress and neonatal asphyxia were lower in the observation group with significant differnces (χ2 value was 6.37 and 5.10, respectively, both P<0.05) .However, neonatal clavicular fracture and brachial plexus injury rate showed no significant differences (χ2 value was 2.75 and 1.01, respectively, both P>0.05).The rate of perineum integrity in the observation group was significantly superior to the control group (χ2 =7.29, P<0.01), and the incidence of postpartum hemorrhage was also lower in the observation group (χ2 =4.35,P<0.05).Conclusion The lateral position delivery can prevent neonatal asphyxia and reduce the incidence of postpartum hemorrhage, perineum injury and lateral episiotomy rate.It is helpful for postpartum recovery.Meanwhile, it can prevent postpartum hemorrhage and it is worthy of being generalized.