运动及自由体位在无创分娩中的应用

2016-09-24邱洪涛王剑鹰

中国妇幼健康研究 2016年2期

关键词：剖宫产

邱洪涛, 王剑鹰，刘　晶

(西北妇女儿童医院，陕西西安 710061)

运动及自由体位在无创分娩中的应用

邱洪涛, 王剑鹰，刘晶

(西北妇女儿童医院，陕西西安 710061)

目的测评第一、二产程中母体的适当节律运动和自由舒适体位在无创分娩中的作用及价值。方法选择西北妇女儿童医院住院分娩的初产、头位单胎，有阴道分娩条件、头盆评分>7分的产妇，年龄21～30岁，孕周37～42周，无严重妊娠并发症及合并症的孕妇。根据意愿分为观察组、对照组(各500例)，观察组为自由体位及运动并配合无创接生组，对照组为传统方法接生组。分别记录两组第一、第二产程时间，中转剖宫产率、阴道助产率，会阴侧切率及产后出血量。结果两组阴道分娩产程时间比较，观察组在第一产程及总产程平均时间均显著低于对照组，两组比较有统计学意义(t值分别为18.383、3.272，均P<0.05)。观察组的无创会阴保护、会阴侧切、中转剖宫产率均显著低于对照组，两组比较具有统计学意义(χ2值分别为100.436、72.030、6.056，均P<0.05)。结论产妇在产程中采用自由体位及运动能够有效的缩短总产程时间，促进自然分娩，减低会阴侧切及剖宫产率。

运动；自由体位；无创分娩；产程

[Abstract]Objective To evaluate the role and value of appropriate rhythmic movement and comfortable postures at the first and second stages of noninvasive labor. Methods In Northwest Women and Children’s Hospital inpatient puerperas with head of singletons and vaginal delivery condition were selected. Their head score was higher than 7 with age of 21 to 30 years and gestational age of 37-42 weeks. They were free from severe pregnancy complications and complications. According to intend they were divided into observation group and control group (500 cases in each group). The observation group took free posture and movement with noninvasive labor, while the control group accepted traditional method. The first and second labor time, transit cesarean delivery rate, the rate of vaginal midwifery, episiotomy rate and postpartum bleeding amount were recorded for two groups. Results Compared with the control group, the first labor and total labor of the observation group were shorter in vaginal delivery time, and the differences were significant (tvalue was 18.383 and 3.272, respectively, bothP<0.05). Noninvasive perineal protection, episiotomy and transit cesarean delivery rate were lower in the observation group, and the differences were significant (χ2value was 100.436, 72.030 and 6.056, respectively, allP<0.05).Conclusion Free posture and movement in labor can effectively shorten total labor time, promote natural childbirth and reduce episiotomy and cesarean section rate.

[Key words]movement; free posture; noninvasive delivery; labor

健康产妇产时运动对心理有益，并能促进产程进展[1]。为减轻产妇分娩痛苦及不必要的干预，保障母婴安全，降低无医疗指征的剖宫产率，测评第一、二产程中母体适当节律运动及自由舒适体位在无创分娩中的作用，本资料中产科医护人员尝试让孕妇在全产程中采取适当节律运动及自由体位，经过临床观察与数据分析，发现产妇在产程中采用适当节律运动及自由体位，能够有效的缩短总产程时间，促进自然分娩．减低会阴侧切及剖宫产率，现将观察报告如下。