会阴切开前综合评估对初产妇妊娠结局的影响

目的 探讨会阴切开前综合评估对初产妇妊娠结局的影响.方法 便利抽样法选取2015年7月至2016年6在上海交通大学医学院附属国际和平妇幼保健院行非限制性会阴切开的400例自然分娩初产妇为研究对象,将2015年7-12月收治的的200例自然分娩初产妇为对照组,2016年1-6月收治的的200例自然分娩的初产妇为观察组.对照组产妇不进行产前综合评估,不限制采用会阴切开术;观察组进行综合评估,根据评估结果选择会阴保护方式.比较两组产妇分娩时的会阴保护方式、产时与产后2h出血量、新生儿Apgar评分等.结果 观察组产妇分娩时的会阴保护方式以自然保护为主,行会阴侧切术的比例、产时与产后2h出血量均明显低于对照组(均P＜0.05);两组新生儿出生后1、5 min的Apgar评分差异均无统计学意义(均P＞0.05).结论 会阴切开前的综合评估有利于降低初产妇会阴切开率,促进正常初产妇安全、舒适地进行分娩.

Effect of Comprehensive Evaluation on the Outcome of Pregnant Women before Perineal Incision

Objective To investigate the impact of comprehensive assessment of the maternalcondition before episiotomy on pregnancy outcome.Methods By convenience sampling,400 cases were selected,200 cases of normal primipara with non-restrictive episiotomy from July to December of 2015 in our hospital was selected as control group,and 200 cases of normal primipara from January to June of 2016 in our hospital was selected as observation group.Control group did not undergo prenatal maternal comprehensive assessments and did not restrict the use of episiotomy.Comprehensive assessments were carried out in the observation group which received the correct choice of the perineum protection based on the results of evaluation.The analysis were obtained between the two groups form the following aspects:the number of cases with different mode of delivery and constituent ratio,the amount of bleeding within incision,postpartum hemorrhage of 2 hours,Apgar score.Results The amount of bleeding within incision and postpartum hemorrhage of 2 hours in observation group were less than control group (all P＜0.05).There was no statistically difference between Apgar score of 1 minute and5 minutes (all P＞0.05).Conclusion Comprehensive assessments of primipara carried out during childbirth could avoid routine episiotomy and is one of the important factor to reduce episiotomy rate.That will energetically promote the safety and comfort in the normal child birth of primipara.