腹直立位待产与分娩结局关系的探讨

Relationship between predelivery of upright position and results of parturition

关键词:  体位  待产  分娩

Key words:  posture  predelivery  parturition

摘要:

［目的］探讨腹直立位待产的优点及对分娩结局的影响。［方法］将待产妇随机分为两组：A组：腹直立位待产组，即产妇进入活跃期后被送进待产室，在宫缩痛时，让产妇采取跪、蹲、坐、下床走动、手扶墙壁摇晃身体等自己认为舒适的体位，不给予机械服务模式干预；B组：卧位待产组，即产妇进入活跃期后，常规被送进待产室，产妇采取传统的左侧卧位待产方式。两组孕妇均由专人看管产程，详细记录产程时间、产后出血量 、新生儿Apgar评分、软产道损伤情况、剖宫产及会阴侧切情况。［结果］腹直立位待产组比卧位待产组产程时间明显缩短，即两组比较，第Ⅰ+第Ⅱ产程差异具有高度显著性，p<0.01，第Ⅲ产程差异具有显著性，p<0.05；腹直立位待产组比卧位待产组剖宫产率低，二者差异具有高度显著性，p=0.01；两组的产后出血量、新生儿Apgar评分、侧切产率及软产道损伤率无显著性差异，p>0.05。［结论］腹直立位待产组比卧位待产组产程时间明显缩短，剖宫产率低。

Abstract:

［Objective］ To investigate advantage of predelivery in upright position and its affection to parturitum result. ［Methods］ Two groups were divided randomly. group A: predelivery group in upright position, the parturients were sent to the predelivery room when they were in active phase, and they were not intervened with any mode of mechanic service. They could take postures which they feel comfortable, such as kneeling position, squatting position, sitting position, walking around or shaking their body with hands against wall, et al. Group B: predelivery group in traditional position lying on left side. The parturients were routinely sent to the predelivery room when they were in active phase, and they took the traditional mode of lying position. All of them in the two groups were specially attended by midwives. delivery course time, the amount of postpartum hemorrhage, Apgar score of newborn, injury of soft birth canal, perineotomy and cesarean section were recorded in detail. ［Results］ Delivery course time in group A was shorter than that in group B. There was significant difference in the first and second delivery curse time between the two groups, p<0.01. There was significant deference in the third delivery course time between the two groups, p<0.05. There was significant difference between the rates of cesarean section in the two groups, p=0.01. The amount of postpartum hemorrhage, Apgar score of ewborn, the rate of perineotomy and the rate of injury of soft birth canal between the two groups, there were no significant differences, p>0.05. ［Conclusion］ Predelivery in upright position shortened delivery course time, reduced the rate of cesarean section.