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Objective To explore the clinical effect of free postnatal delivery in the second stage of labor, and to provide evidence for clinical midwifery. Methods From March 2016 to November 2017, 120 maternity patients from the First People′s Hospital of Hefei were selected and divided into research group and control group, using simple random grouping and the method of random number table, with 60 cases in each group. At the second stage of delivery, the research group used free body position at different stages, while the control group took the position of supine bladder lithotomy position. The delivery outcome, duration of the second stage, postpartum vaginal bleeding within two hours, newborn asphyxia rate, degree of perineal laceration, perineum incision rate, delivery comfort and satisfaction and midwives job satisfaction were compared. Results The vaginal delivery rate of the research group was 96.7％(58/60), which was higher than that of the control group 86.7％ (52/60). The difference was statistically significant (χ2=3.93, P<0.05). The duration of the second stage in the research group was (31.97 ± 9.85) minutes, and that of the control group was (39.50 ± 12.19) minutes. There was a statistically significant difference between the two groups (t=-3.357, P<0.05). There was no significant difference in neonatal asphyxia rate and the amount of postpartum vaginal bleeding within 2 hours between the two groups (P>0.05). The perineum integrity rate in the research group was 10.4％(6/58), higher than that in the control group, which was 0. Perineal side cut rate in the research group was 0, lower than that in the control group, which was 21.1％(11/52). The difference was statistically significant (χ2=11.31, 13.63, P<0.05). Deliverycomfort, delivery satisfaction and midwives job satisfaction in the research group were 91.7％ (55/60), 100.0％ (60/60) and 100.0％ (60/60) respectively, while delivery comfort, delivery satisfaction and midwives job satisfaction in the control group were 38.3％(23/60), 83.3％(50/60) and 76.7％(46/60). The differences were statistically significant (χ2=37.51, 10.91, 15.85, P<0.05). Conclusion The second labor stage free position is effective safe childbirth way of delivery, which can improve the natural births, shorten the labor, lighten the perineal injury, improve the puerpera childbirth comfort and satisfaction, it also raised the midwives job satisfaction, and had no adverse effect on maternal and infant outcomes, so the method has clinical application and dissemination value.
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OBJECTIVE@#To observe the effects of the combined therapy of the auricular-point pressure at the free position and the unprotected perineal delivery technique during the 2nd stage of labor in the primiparas so as to improve the clinical delivery quality.@*METHODS@#A total of 146 primiparas who accepted the natural delivery willingly were collected. According to the visit sequence, they were divided into an observation group (72 cases) and a control group (74 cases). The free position and the unprotected perineal delivery were adopted in combination during the labor in both of the two groups. Additionally, in the observation group, the auricular-point pressure with semen vaccariae was intervened when entering the active phase. The points were pengqiang (TF), zigong (uterus), neishengzhiqi (TF), pizhixia (AT), shenmen (TF), jiaogan (AH), pi (CO) and wei (CO). Each point was pressed for 1 to 2 min each time, repeated once every 10 to 20 min until the end of the 2nd stage of labor. The episiotomy rate, perineal laceration degree, perineal pain degree, the duration of the 2nd labor stage, postpartum hemorrhage, postpartum urine retention and neonatal asphyxia rate were recorded and compared in the primiparas between the two groups.@*RESULTS@#The perineal laceration of the degree Ⅲ and Ⅳ did not occur in the two groups. Compared with the control group, the effect on the perineal laceration was better in the observation group (0.05). In the observation group, the neonatal asphyxia rate was 1.4% (1/72), the postpartum hemorrhage 6.9% (5/72) and the incidence of urine retention 5.6% (4/72), all lower than 10.8% (8/74), 18.9% (14/74) and 17.6% (13/74) in the control group respectively (all <0.05). In the observation group, on the 1st, 2nd and 3rd days after labor, the perineal pain degree and the duration of the 2nd stage of labor were superior to the control group (all <0.001).@*CONCLUSION@#The combined therapy of the auricular-point pressure intervention at the free position and the unprotected perineal delivery technique effectively reduces the episiotomy rate and perineal laceration degree, relieves the perineal pain, reduces the neonatal asphyxia rate and improves the delivery quality during the 2nd stage of labor in the primiparas.
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Female , Humans , Pregnancy , Labor, Obstetric , Parity , Perineum , PressureABSTRACT
Objective To discuss the influence of pudendal nerve block anesthesia on pain degree and labor course when presentation at different positions during the second stage of labor,in order to find the better anesthesia timing and method to reduce pain,shorten labor,increase maternal comfort to a maximum extent and provide the best service for the maternal.Methods 200 cases of primiparas with fullterm and single-birth were selected and numbered randomly,patients with odd numbers were set to the observation group,patients with even numbers were set to the control group,100 cases in each group.In the observation group,when the presentation reached S+1,1％ lidocaine was used to perform pudendal nerve block anesthesia.In the control group,the pudendal nerve block anesthesia was performed before perineal incision.Results The pain intensity,time of the second labor stage,perineum damage degree between the two groups were statistically different.The observation group with Ⅱ-grade level,Ⅲ-grade level pain were 32 cases less than that of the control group.The perineum incision later crack number in the observation group was 24 cases less than that of the control group.The number of delivery within 1 hour in the second labor process in the observation group was 21 cases more than that in the control group.Conclusions Implementation of bilateral pudendal nerve block anesthesia in the second stage of labor when the presentation reaches S+1 can alleviate childbirth pain,shorten the second stage of labor,reduce the degree of perineal trauma.
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Objective To investigate the feature and the safety of birth process of induced labor by Propess.Methods The 380 cases of vaginal delivery women in our hospital between Sep.2006 to Dec.2007 who, were primigravida,term delivery,singleton gestation,vertex presentations and no standing contraindication, was considered as study group. The other 380 cases of women of labor spontaneous or intravenous oxyvenous in the same condition was considered as control group.The birth process,the amount of bleeding,the number of urine retention,and the prognosis of neonate were compared between the two group.Results The active phase and the second stage was abbreviated in the study group,(P0.05).Conclusion Propess was more effective and safe in shortening the active phase, the secona stage and reducing complications.