第二产程分阶段自由体位分娩的临床研究

目的 探讨第二产程分阶段采用自由体位分娩的临床效果。 方法 选取愿意接受自然分娩的初产妇120例,根据随机数字表法分为观察组(n=60)和对照组(n=60),观察组第二产程初期采用站立位、半坐位、蹲位3种垂直体位分娩,产妇根据自身主观意愿自由交替选择调整分娩体位;第二产程末期胎头拨露后采取侧卧位接产;对照组第二产程全程取仰卧膀胱截石位分娩。对比2组分娩结局、第二产程时长、产后2 h出血量、新生儿窒息率、会阴裂伤程度、分娩舒适度和满意度。 结果 观察组阴道分娩率高于对照组,差异有统计学意义(P<0.05);2组新生儿窒息率、产后2 h出血量比较,差异无统计学意义(均P>0.05);观察组第二产程时长低于对照组,差异有统计学意义(P<0.05);观察组会阴完整率、会阴侧切率均优于对照组,差异有统计学意义(均P<0.05);观察组产妇分娩舒适度、满意度均高于对照组,差异均有统计学意义(均P<0.05)。 结论 第二产程分阶段自由体位分娩是有效安全的分娩方式,可提高自然分娩率,缩短第二产程,减轻会阴损伤,提高产妇分娩舒适度,且对母婴结局无不良影响,具有临床应用价值。 

Clinical study of the second stage of labor stage free position delivery

Objective To investigate the clinical effect of the second stage of labor stages by free delivery position. Methods One hundred and twenty cases of primipara accepted natural childbirth were selected according to the order of admission were randomly divided into observation group (n=60) and control group (n=60), the observation group at the beginning of the second stage of labor by standing, half sitting, squatting three vertical position childbirth, maternal according to their own subjective hope free alternative selection adjustment delivery the position of the second stage of labor; at the end of the fetal head exposed after taking lateral position shifting production; the control group in the second stage of labor throughout the supine lithotomy position delivery. The birth outcomes, length of the second stage of labor, postpartum hemorrhage and neonatal asphyxia rate 2 h, perineal laceration, comfort and satisfaction of delivery in the two groups were compared. Results In the observation group, the vaginal delivery rate was higher than the control group, the difference was statistically significant (P<0.05). The neonatal asphyxia, postpartum hemorrhage 2 h comparison in the two groups had no statistically significant difference (P>0.05). The second stage of labor time length in the observation group was lower than the control group, the difference was statistically significant (P<0.05). The perinaeum integrity and episiotomy rate in the observation group were better than the control group, the difference was statistically significant (P<0.05). The maternal comfort and satisfaction in the observation group were higher than the control group, the differences were statistically significant (P<0.05). Conclusion The second stage of labor stage free position childbirth way of birth is safe and effective. It can improve the rate of natural childbirth, shorten the second stage of labor, reduce perineal injury, improve maternal comfort and have good effects on maternal and neonatal outcomes are, with clinical application.