摘要
目的分析初产妇阴道分娩会阴侧切助产的影响因素,为降低初产妇会阴侧切率提供临床参考。方法收集2015年4月至2017年3月经阴道分娩的初产妇1205例,统计分析会阴侧切情况,对会阴侧切的因素进行单因素和Logistic多元回归分析。结果1205例初产妇中会阴侧切率为72.7%。将876例会阴侧切产妇纳入侧切组,余下未行会阴侧切者329例纳入未侧切组。侧切组年龄>28岁、妊娠合并症、第2产程延长、会阴条件差、胎吸产钳助产、羊水污染、胎儿体重>3500g、胎儿宫内窘迫、助产士工龄≤3年、静滴催产素的比例明显高于未侧切组,使用无保护分娩法的比例明显低于未侧切组,差异均有统计学意义(均P<0.05);Logistic多元回归分析显示,年龄、妊娠合并症、第2产程延长、会阴条件差、胎吸产钳助产、羊水污染、胎儿体重、胎儿宫内窘迫、助产士工龄、静滴催产素是初产妇会阴侧切的影响因素。结论初产妇经阴道分娩会阴侧切助产与多种因素有关,需综合考虑,除了产妇及胎儿因素外,还需重视助产工作制度及会阴侧切标准建立并不断改善优化,从而达到最大限度降低会阴侧切率,最终改善产妇产后生活质量。
Objective To analyze the influencing factors of midwifery lateral episiotomy for primipara vaginal delivery, so as to provide clinical reference for reducing the rate of lateral episiotomy of primipara. Methods 1 205 primipara who delivered via vagina were collected from April 2015 to March 2017. The circumstance of lateral episiotomy was analyzed statistically. The influencing factors of lateral episiotomy were analyzed by single factor and logistic multiple regression analysis. Results The rate of lateral episiotomy in 1 205 primipara was 72.7%(876 cases). The proportion of age over 28 years old, pregnancy complications, prolonged second stage of labor process, poor perineal conditions, fetal obstetric forceps midwifery, amniotic fluid pollution, fetal weight over 3 500 g, fetal intrauterine distress, midwives' length of service less than 3 years, intravenous drip of oxytocin in the lateral episiotomy group were higher than those in the non-lateral episiotomy group (P<0.05), the proportion of unprotected delivery was significantly lower than that in the non-lateral episiotomy group (P<0.05). Logistic multiple regression analysis showed that age, pregnancy complications, prolonged second stage of labor process, poor perineal conditions, fetal obstetric forceps midwifery, amniotic fluid pollution, fetal weight, fetal intrauterine distress, midwives' length of service, intravenous drip of oxytocin were the influencing factors of lateral episiotomy for primipara. Conclusions Midwifery lateral episiotomy for primipara vaginal delivery is related to many factors, which should be considered comprehensively. In addition to maternal and fetal factors, attention should be paid to the establishment of midwifery work system and the standard of lateral episiotomy and continuous improvement and optimization, so as to minimize the rate of lateral episiotomy and ultimately improve the quality of postpartum life.
作者
王桂荣
王飞飞
Wang Guirong;Wang Feifei(Department of Gynaecology and Obstetrics, Wendeng Central Hospital of Weihai City, Weihai 264400, China;Operation Room, Weihai Central Hospital, Weihai 264400, China)
出处
《国际医药卫生导报》
2019年第6期958-960,共3页
International Medicine and Health Guidance News
关键词
初产妇
阴道分娩
会阴侧切
影响因素
Primipara
Vaginal delivery
Lateral episiotomy
Influencing factor
