摘要
目的探讨将无创自然分娩模式在基层专科医院逐步开展。方法 选择2017年4月至2019年1月在本院计划生育服务中心产科经阴道分娩的580例正常初产妇,随机将其分为两组,各290例。对照组按常规当胎头拨露使阴唇后联合紧张时,开始保护会阴。观察组则采用无创接生技术,助产士在产妇分娩过程中用单手控制胎头娩出速度,用拉玛泽呼吸法指导产妇进行屏气和哈气,合理控制好胎头下降速度,使胎头下降对阴道产生的压力均匀分布,待会阴充分扩张后,胎儿便会顺利娩出。比较两组产妇在会阴情况、新生儿窒息、产后出血、产后尿潴留、产妇满意度等情况。结果 观察组会阴侧切率28.6%,低于对照组50.0%,会阴Ⅰ°裂伤率47.6%,高于对照组24.1%,差异均有统计学意义(均P<0.05);观察组产妇满意度93.1%,高于对照组67.2%,差异有统计学意义(P<0.05);观察组产后尿潴留率13.1%,高于对照组0.7%,差异有统计学意义(P<0.05);两组会阴Ⅱ°裂伤率、会阴正中切口率、会阴完整率、新生儿窒息率、产后出血率比较,差异均无统计学意义(均P>0.05)。结论无创自然分娩降低了会阴侧切率、提升了产妇满意度,加快了产妇产后康复,提高产妇生活质量,提升本院产科质量,值得推广,由于本院刚刚开展这项业务,技术不是很成熟,产后尿潴留发生率较高,在今后的工作中进一步改进。
Objective To explore the gradual development of non-invasive natural delivery mode in primary hospitals. Methods 580 normal primiparae having vaginal delivery at maternal and child health and family planning service center in Heshan from April, 2017 to March, 2019 were randomly divided into an observation group and a control group, 290 cases for each group. In the control group, when the fetal head was exposed, the perineum was protected. The observation group used non-invasive delivery technology;midwives used one hand to control the delivery speed of the fetal head during the delivery;Lamaze's breathing method was used to guide the mother to hold her breath and to breathe;and the spped of fetal head drop was reasonably controlled so that the pressure generated by the fetal head drop on the vagina was evenly distributed;after the full expansion of the perineum, the fetus would be delivered smoothly. The perineum, neonatal asphyxia, postpartum hemorrhage, postpartum urine storage, and maternal satisfaction were compared between the two groups. Results The vaginal lateral cut rate was significantly lower and the incidence of perineum I° fracture, maternal satisfaction, and incidence of postpartum urinary retention were significantly higher in the observation group than in the control group (28.6% vs. 50.0%, 47.6% vs. 24.1%, 93.1% vs. 67.2%, and 13.1% vs. 0.7%, all P < 0.05). There were no statistical differences in perineum Ⅱ° fracture, perineum median incision, perineum integrity, neonatal asphyxia, and postpartum hemorrhage between these two groups (all P > 0.05). Conclusions Non-invasive natural childbirth has reduce the rate of perineotomy, improved maternal satisfaction, maternal quality of life, obstetric quality, and accelerated postpartum recovery at our hospital. It is worth promoting. Since our hospital has just started this business, the technology is not very mature. The incidence of postpartum urine storage is high, the technology should be further improved in the future work.
作者
鲁海珍
Lu Haizhen(Heshan Women and Children's Health Hospital)
出处
《国际医药卫生导报》
2019年第10期1621-1624,共4页
International Medicine and Health Guidance News
关键词
无创自然分娩
产科质量
应用研究
Noninvasive natural childbirth
Obstetric quality
Application research
