自由体位对产程及胎方位的影响(1)
[摘要]目的 研究分娩过程中采用自由体位对产妇产程及胎儿胎方位的影响。方法 选取2016年10月～2017年10月我院收治待产产妇86例作为研究对象，按随机数字表法分为两组，各43例。对照组孕妇采用传统体位待产，观察组产妇采用自由体位待产。观察两组产妇的胎方位、分娩方式、产程情况以及分娩结局。结果 观察组孕妇的枕前位、自然分娩比例均高于对照组，枕横位、中转剖宫产比例均低于对照组(P<0.05)。观察组孕妇潜伏期、活跃期、第二产程时间均明显短于对照组(P<0.05)。两组患者产后出血、新生儿窒息发生率差异无统计学意义(P>0.05)；观察组孕妇宫颈水肿和使用催产素的比例明显低于对照组，差异均有统计学意义(P<0.05)。结论 自由体位分娩明显缩短产程，减少催产素的使用，改善妊娠结局，值得临床应用及推广。
[关键词]自由体位；产程；胎方位；影响
[中图分类号] R714.3 [文献标识码] A [文章编号] 1674-4721(2018)3(b)-0086-03
The influence of free posture on the birth process and fetal orientation
HUANG Li-Zhen
Department of Obstetrics，Maternal and Child Health Care Hospital of Huidong County，Guangdong Province，Huidong 516300，China
[Abstract]Objective To study the clinical effect of free posture in the labor stage and fetal position.Methods Eighty-six puerpera delivered from October 2016 to October 2017 in our hospital were selected.The subjects were randomly divided into two groups，43 cases in each group.The control group was adopted the conventional delivery posture；the observation group was adopted the free delivery posture.The fetal position，delivery modes，labor stage and delivery outcomes were observed.Results The rate of occipitoanterior position and natural labor for observation group was significantly higher than that the control group；the rate of occipitotransverse position and transformation from natural labor to cesarean section for observation group was significantly lower than that in the control group (P<0.05)；the incubation period，active phase and second labor stage courses for observation group were significantly shorter than that in control group (P<0.05)；the rate of postpartum hemorrhage and neonatal asphyxia for two groups was not significantly different (P>0.05)；the incidence rate of cervical edema and dosage of oxytocin for observation group were significantly lower than that in the control group，the differences were statistically significant(P<0.05).Conclusion The scientific free posture can greatly shorten the labor stage，reduce the dosage of oxytocin and improve the pregnancy outcomes.
[Key words]Free posture；Labor stage；Fetal position；Influence
仰臥位是临床上传统的分娩时体位，仰卧位存在诸多不足，分娩时胎儿不能有效地压迫宫颈，宫口开大时间长，第一产程时间明显延长压迫腹主动脉，导致胎盘循环受阻；压迫下腔静脉，导致仰卧位低血压综合征的发生；骨盆可塑性受限，生产难度增加；增加产妇疼痛[1-2]，因此人们认为[3]，在分娩过程中给予产妇自主选择舒适体位更加人性化，符合产妇需求。现代产科服务体系倡导自由体位分娩。自由体位分娩的概念，就是在孕产妇及胎儿健康状况良好的前提下，孕产妇可在助产士指导下，自由选择自己感觉舒服的产前活动体位及分娩姿势，如蹲位、站位、跪位、俯卧位、趴位、坐位等，使分娩方式回归自然，舒缓紧张情绪，缓解疼痛，缩短产程。且通过姿势的调整，也能影响宫缩、产力、产道、胎方位，增加骨盆出口横径等因素，让分娩更为顺利。传统的平躺在床上待产和分娩，会缩小骨盆的径线，对抗地心引力，让胎儿难以旋转下降到最佳胎位，同时也增加产妇的不适，增加了分娩的难度，自由体位分娩可让胎儿和产妇的骨盆相互适应，使胎儿更加容易入盆，加快宫口扩张，降低胎儿缺氧风险。本文对我院分娩产妇进行自由体位分娩，观察自由体位待产及分娩对产妇的影响，现报道如下。, 百拇医药(黄丽珍)
[关键词]自由体位；产程；胎方位；影响
[中图分类号] R714.3 [文献标识码] A [文章编号] 1674-4721(2018)3(b)-0086-03
The influence of free posture on the birth process and fetal orientation
HUANG Li-Zhen
Department of Obstetrics，Maternal and Child Health Care Hospital of Huidong County，Guangdong Province，Huidong 516300，China
[Abstract]Objective To study the clinical effect of free posture in the labor stage and fetal position.Methods Eighty-six puerpera delivered from October 2016 to October 2017 in our hospital were selected.The subjects were randomly divided into two groups，43 cases in each group.The control group was adopted the conventional delivery posture；the observation group was adopted the free delivery posture.The fetal position，delivery modes，labor stage and delivery outcomes were observed.Results The rate of occipitoanterior position and natural labor for observation group was significantly higher than that the control group；the rate of occipitotransverse position and transformation from natural labor to cesarean section for observation group was significantly lower than that in the control group (P<0.05)；the incubation period，active phase and second labor stage courses for observation group were significantly shorter than that in control group (P<0.05)；the rate of postpartum hemorrhage and neonatal asphyxia for two groups was not significantly different (P>0.05)；the incidence rate of cervical edema and dosage of oxytocin for observation group were significantly lower than that in the control group，the differences were statistically significant(P<0.05).Conclusion The scientific free posture can greatly shorten the labor stage，reduce the dosage of oxytocin and improve the pregnancy outcomes.
[Key words]Free posture；Labor stage；Fetal position；Influence
仰臥位是临床上传统的分娩时体位，仰卧位存在诸多不足，分娩时胎儿不能有效地压迫宫颈，宫口开大时间长，第一产程时间明显延长压迫腹主动脉，导致胎盘循环受阻；压迫下腔静脉，导致仰卧位低血压综合征的发生；骨盆可塑性受限，生产难度增加；增加产妇疼痛[1-2]，因此人们认为[3]，在分娩过程中给予产妇自主选择舒适体位更加人性化，符合产妇需求。现代产科服务体系倡导自由体位分娩。自由体位分娩的概念，就是在孕产妇及胎儿健康状况良好的前提下，孕产妇可在助产士指导下，自由选择自己感觉舒服的产前活动体位及分娩姿势，如蹲位、站位、跪位、俯卧位、趴位、坐位等，使分娩方式回归自然，舒缓紧张情绪，缓解疼痛，缩短产程。且通过姿势的调整，也能影响宫缩、产力、产道、胎方位，增加骨盆出口横径等因素，让分娩更为顺利。传统的平躺在床上待产和分娩，会缩小骨盆的径线，对抗地心引力，让胎儿难以旋转下降到最佳胎位，同时也增加产妇的不适，增加了分娩的难度，自由体位分娩可让胎儿和产妇的骨盆相互适应，使胎儿更加容易入盆，加快宫口扩张，降低胎儿缺氧风险。本文对我院分娩产妇进行自由体位分娩，观察自由体位待产及分娩对产妇的影响，现报道如下。, 百拇医药(黄丽珍)