The effect of improved hand and knee delivery position on primipara delivery outcome and comfort

doi:10.3761/j.issn.0254-1769.2021.05.012

Abstract

Abstract:

Objective To evaluate the effect of improved hand knee delivery on the outcome and comfort of primipara in the second stage of labor.Methods From October 1,2019 to March 31,2020,290 primiparas delivered in the delivery center of a tertiary hospital were selected as the study population. With informed consent,the study method of randomized controlled trial was adopted. According to the method of randomized numerical table,the study group was divided into an experimental group（n=145）and a control group（n=145）. The experimental group adopted the improved hand knee delivery position in the second stage of labor,and the control group adopted the traditional knee-bent supine position in the second stage of labor. The difference of delivery outcome and comfort between the 2 groups was compared.Results The natural delivery rate of parturients in the experimental group was higher than that in the control group（χ²=12.590）;the rate of episiotomy was lower than that in the control group（χ²=48.019）;the second labor period was shorter than that of the control group（t=-2.579）;the amount of bleeding during and after delivery was less than that of the control group（t=-2.134）;the maternal comfort was higher than that of the control group（t=-10.775）;the difference was statistically significant（P<0.05）. There was no significant difference in neonatal asphyxia rate between the 2 groups（χ²=0.344,P=0.995）. Conclusion The improved hand knee delivery position can improve the natural delivery rate,shorten the second labor period,reduce the rate of dystocia and lateral episiotomy,reduce postpartum hemorrhage,and improve the comfort of delivery.

Key words: Improved Hand Knee, Primipara, Delivery Outcome, Comfort, Obstetrical Nursing

摘要：

目的评价第二产程中采用改良式手-膝位分娩对初产妇分娩结局和舒适度的影响。方法选取2019年10月1日—2020年3月31日在西安市某三级甲等医院产房中心分娩的290名初产妇为研究对象,采用随机数字表法分为试验组（n=145）和对照组（n=145）,试验组在第二产程采用改良式手-膝位分娩,对照组采用屈膝半卧位分娩,比较两组分娩结局和舒适度的差异。结果试验组自然分娩率高于对照组（χ²=12.590）、会阴侧切率低于对照组（χ²=48.019）、第二产程时间短于对照组（t=-2.579）、产时及产后2 h出血量少于对照组（t=-2.134）、分娩舒适度问卷得分高于对照组（t=-10.775）,差异具有统计学意义（均P<0.05）;两组新生儿窒息率比较,差异无统计学意义（χ²=0.344,P=0.995）。结论改良式手-膝位分娩可提高产妇自然分娩率,缩短第二产程时间,降低会阴侧切率,减少产后出血,提高产妇分娩舒适度。

关键词: 改良式手膝位, 初产妇, 分娩结局, 舒适度, 产科护理

LÜ Hairong,BAO Lei,LUO Li,SUN Yani,WANG Hongli,REN Yu,ZHAI Jinguo. The effect of improved hand and knee delivery position on primipara delivery outcome and comfort[J]. Chinese Journal of Nursing, 2021, 56(5): 716-720.

吕海荣,暴蕾,罗莉,孙亚妮,王红利,任毓,翟巾帼. 改良式手-膝位分娩对初产妇分娩结局和舒适度的影响[J]. 中华护理杂志, 2021, 56(5): 716-720.

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