自由体位联合徒手旋转胎头在枕横和枕后位孕妇第二产程中的应用效果

目的探讨自由体位联合徒手旋转胎头对枕横和枕后位孕妇第二产程中应用效果及对母婴结局的影响。方法选取自然待产的100例单胎初产，按照就诊先后顺序分为对照组（50例）和观察组（50例）。对照组第二产程全程采取自由体位分娩方式；观察组第二产程全程采用自由体位联合联合徒手旋转胎头分娩方式。对比2组产妇第二产程时间、产后2 h出血量、转位成功率、分娩方式、母婴并发症情况等方面的差异。结果与对照组比较，观察组产妇第二产程耗时缩短、产后2 h出血量降低，差异均具有统计学意义（P＜0.01）。观察组产妇阴道分娩率高于对照组（P＜0.05），2组转位成功率差异无统计学意义（P>0.05）。2组产妇产后出血、宫颈裂伤、新生儿宫内窘迫及窒息等不良反应总发生率差异无统计学意义（P>0.05）。结论自由体位联合徒手旋转胎头在第二产程中纠正枕横位和枕后位的应用效果明显，有助于缩短第二产程时间、提高阴道分娩率。

The application effects of free position combined with free hand rotation of fetal head in the second stage of labor in the cross-occipital and retrooccipital pregnant women

ObjectiveTo investigate the application effects of free position combined with freehand rotation of fetal head in the second stage of labor in the cross-occipital and retrooccipital pregnant women, and its effects on maternal and infant outcomes.MethodsOne hundred puerpera with single birth were divided into the control group(50 cases) and observation group(50 cases) by random number table method.The free posture delivery in the control group were adopted throughout the second labor process, and the free posture combined with freehand rotation of fetal head in the observation group were adopted during the second labor process.The differences of the second labor process, 2 h postpartum blood loss, translocation success rate, delivery mode, maternal and infant complications were compared between two groups.ResultsCompared with the control group, the duration of the second stage of labor was shortened, and the postpartum 2 h blood loss decreased in the observation group, and the difference of which between two groups was statistically significant(P < 0.01).The rate of vaginal delivery in observation group was higher than that in control group(P < 0.05), but there was no statistical significance in the success rate of translocation between two groups(P>0.05).The differences of the total incidence rates of postpartum hemorrhage, cervical laceration, neonatal distress and asphyxia were not statistically significant between two groups(P>0.05).ConclusionsThe free positon combined with freehand rotation of fetal head in the application of the second stage of labor can corret the transverse and posterior occipital positions, help to shorten the labor time and improve the rate of vaginal delivery.