助产士门诊干预对首次剖宫产再次妊娠孕妇分娩结局的影响研究

目的探讨助产士门诊干预对首次剖宫产后再次妊娠孕妇分娩结局的影响。方法收集2016年1~11月广州市花都区妇幼保健院首次剖宫产后再次妊娠的孕妇123例作为研究对象,按照随机数字表法将其分成两组。对照组61例接受常规产检门诊宣教和参加瘢痕子宫阴道分娩专家门诊,研究组62例在对照组的基础上实施助产士门诊干预,比较两组孕妇分娩方式、产后出血量、3个产程及总产程时间、新生儿出生体重与出院前母乳喂养率。结果研究组顺产率、新生儿出生体重、产后出血量、第二产程时间、出院前母乳喂养率均优于对照组(P0.05);研究组第一产程、第三产程和总产程时间与对照组比较,差异无统计学意义(P0.05)。结论实施助产士门诊干预能提高首次剖宫产后再次妊娠孕妇的顺产率、出院前母乳喂养率,改善母婴分娩结局,值得临床推广。

Study on the delivery outcome of midwife outpatient intervention on pregnant women after first-time cesarean section

Objective To study the effect of midwife outpatient intervention on delivery outcome of pregnant women after first-time cesarean section.Methods 123 pregnant women after first-time cesarean section were collected as the research object from January 2016 to November 2016 in Guangzhou Huadu District Maternal and Child Health Care Hospital.They were randomly divided into two groups.The control group of 61 pregnant women received routine prenatal outpatient service mission and the scar uterus vaginal delivery (vaginal birth after cesarean section,VBAC) expert outpatient service.The study group of 62 pregnant women received the midwife outpatient intervention besides the routines of the control group.Compared the two groups on pregnant women delivery mode,postpartum hemorrhage,three labor and total labor time,newborn birth weight and breastfeeding rate before discharge.Results The maternal birth rate,neonatal birth weight,postpartum hemorrhage,second stage labor time and breastfeeding rate before discharge of the study group were better than the control group (P<0.05);First,third stage and total labor time of the study group compared with the control group,the difference was not statistically significant.Conclusion Implementation of midwife outpatient intervention can improve vaginal delivery rate and breastfeeding rate before discharge of pregnant women after first-time cesarean section.It is worthy of clinical promotion.Thus improve the outcome of maternal and child delivery and worthy of clinical promotion.