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自由体位分娩对产妇分娩结局及盆底功能的影响
Effects of free-posture parturition on parturition outcomes and pelvic floor function in puerperae

张静 陈江鸿 刘丽 林佳静 胡敏 黄英

Zhang Jing, Chen Jianghong, Liu Li, Lin Jiajing, Hu Min, Huang Ying

【摘要】目的 观察自由体位分娩对分娩结局及产后盆底功能的影响。方法 采用前瞻性随机对 照临床试验方法,将符合要求的孕妇270 名随机分为观察组及对照组各135 名,观察组孕妇采取自由体 位分娩,对照组孕妇采用目前常用的平卧位分娩,两组孕妇均按现行产程标准进行管理,观察自由体位 分娩对分娩结局及产后盆底功能的影响。结果 观察组自然分娩133 名,中转剖宫产2 名,对照组自然 分娩102 名,中转剖宫产33 名,两组间分娩方式比较差异有统计学意义(χ2=31.55,P < 0.001);观察组 初产妇第一、第二产程级总产程时间较对照组缩短,差异有统计学意义(P< 0.001);而经产妇中各产程 时间差异无统计学意义(P > 0.05)。观察组初产妇Ⅰ类、Ⅱ类肌纤维肌力降低发生率低于对照组,差异 有统计学意义(P< 0.05);而经产妇Ⅰ类、Ⅱ类肌纤维肌力降低发生率与对照组比较差异无统计学意义 (P>0.05)。两组产妇产后尿失禁发生率比较差异无统计学意义(P> 0.05)。结论 应用自由体位分娩, 可显著降低剖宫产率,初产妇产程时间显著缩短,且盆底肌力优于对照组,未增加母儿不良结局。
【摘要】Objective To observe the effects of free-posture parturition on the parturition outcomes and pelvic floor function of puerperae. Methods Totally 270 pregnant women who met the requirements were divided into an observation group( n=135) and a control group( n=135) by the prospective randomized controlled clinic trail. Pregnant women in the observation group adopted free-posture parturition, while pregnant women in the control group delivered in the frequently used supine position. The pregnant women in both groups were managed according to the existing labor standards, and the effects of free-posture parturition on their parturition outcomes and pelvic floor function were observed. Results Totally 133 pregnant women in the observation group delivered naturally and 2 transferred to cesarean parturition in the process, while 102 pregnant women in the control group delivered naturally and 33 transferred to cesarean parturition in the process( χ2=31.55, P< 0.001). The uniparae in the observation group spent less time in the first and second stages of labor as well as the whole parturition than the uniparea in the control group( P<0.001). There was no statistically significant difference in the duration of labor stage between the multiparae in the two groups( P > 0.05). The uniparae in the observation group were less likely to show reduced type Ⅰ and type Ⅱ muscle fiber strength than the uniparae in the control group( P<0.05), while there was no statistically significant difference in the incidence of reduced typeⅠand type Ⅱ muscle fiber strength between the multiparae in the two groups( P>0.05). There was no statistically significant difference in the incidence of urinary incontinence between the puerparae in the two groups( P>0.05). Conclusions The use of free-posture parturition can reduce the possibility of cesarean parturition substantially. The duration of labor stage in uniparae can be shortened significantly, and their pelvic floor muscle strength is better than that of the puerparea in the control group. Free-posture parturition does not contribute to negative outcomes of maternals and fetals.

【关键词】分娩; 自由体位; 分娩结局; 盆底功能
【关键词】Parturition; Free-posture; Parturition outcome; Pelvic floor function