摘要
目的评价产妇体位对巨大儿分娩的影响。方法将2017年11月至2018年11月我院经B超结合临床提示胎儿体质量4000~4500 g(巨大儿)的200例产妇进行回顾性研究,根据随机双盲法分为两组,各100例。对照组接受卧位待产和分娩,实验组实施自由体位待产和分娩。对比两组分娩结局、产道裂伤情况、产程时间及焦虑情况、母婴结局。结果与对照组比较,实验组顺产率更高,剖宫产率、肩难产率更低(P<0.05);实验组会阴Ⅰ度裂伤、会阴Ⅱ度裂伤、会阴Ⅲ度裂伤、会阴侧切及宫颈裂伤比例更低(P<0.05);第一、二产程时间及VAS-A评分更低(P<0.05);产后出血率、新生儿并发症发生率更低(P<0.05)。结论巨大儿产妇采用自由体位分娩利于降低剖宫产率,减轻产道裂伤程度,促进产程进展,缓解分娩焦虑,改善母婴结局。
Objective To evaluate the influence of posture of pregnant women on delivery of macrosomia.Methods 200 pregnant women with fetus weighed 4000-4500 g(macrosomia)confirmed by B-ultrasound from November 2017 to November 2018 were enrolled in this study,and they were divided into two groups by randomized controlled method.The control group received supine position and delivery,and the experimental group performed free position and delivery.Compare the two-part outcome,the birth canal laceration,the time of labor and anxiety,and the maternal and child outcomes.Results Compared with the control group,the experimental group had higher cis yield,and the cesarean section rate and shoulder difficulty rate were lower(P<0.05).In the experimental group,the degree of perineal Ⅰ degree laceration,perineal Ⅱ degree laceration,perineal Ⅲ degree laceration,perineal side cut and cervical laceration were lower(P<0.05).The first and second labor time and VAS-A scores were lower(P<0.05).The incidence of postpartum hemorrhage and neonatal complications was lower(P<0.05).Conclusion The delivery with free posture for pregnant women with macrosomia can decrease the cesarean section rate,reduce laceration of birth canal,promote progress of labor,relieve delivery anxiety and improve mother and fetus outcome.
作者
姜丽利
倪小玲
徐金娥
JIANG Li-li;NI Xiao-ling;XU Jin’e(Department of Obstetrics,Suqian People’s Hospital of Nanjing Drum-Tower Hospital Group,Suqian 223800,China)
出处
《中国医药指南》
2019年第35期1-2,共2页
Guide of China Medicine
关键词
巨大儿分娩
自由体位
分娩方式
母婴结局
Delivery of macrosomia
Free posture
Delivery mode
Mother and fetus outcome
