The application of freehand rotating fetal head combined with lateral prone position delivery in the second stage of labor in the head position
第二产程中徒手旋转胎头联合侧俯卧位分娩在头位难产初产妇助产护理中的应用

摘要

目的 分析第二产程中徒手旋转胎头联合侧俯卧位分娩用于头位难产初产妇助产护理的价值。方法随机均分2022年4月-2024年3月某院产房阴道分娩过程中符合临床诊断头位难产的产妇（n=68）。试验组采取第二产程中徒手旋转胎头联合侧俯卧位分娩，对照组行常规助产护理。对比两组阴道分娩成功率、第一第二产程时间、母婴并发症等指标。结果 阴道分娩成功率：试验组达到94.12%显著高于对照组为73.53%（P＜0.05）；第一和第二产程时间：试验组均短于对照组（P＜0.05）；并发症：试验组5.88%显著低于对照组26.47%，（P＜0.05）；SDS和SAS评分：干预后，试验组低至（33.18±4.26）分、（34.71±5.02）分，对照组达到（46.73±5.83）分、（47.31±6.42）分，试验组数据更低（P＜0.05）。结论 头位难产助产护理中采取第二产程中徒手旋转胎头联合侧俯卧位分娩，能够提高产妇的阴道分娩成功率，缩短产程，减少并发症，改善心态。安全可行，利于推广。

Abstract

Objective To analyze the value of freehand rotating fetal head and delivery for midwifery care in the second stage of labor.
Methods Randomized women during vaginal delivery in a hospital from April 2022 to March 2024 (n=68). The test group took the freehand rotation head combined side prone position in the second stage of labor, and the control group underwent routine midwifery care. The success rate of vaginal delivery, the time of the first and second stages of labor, and maternal and infant complications were compared between the two groups.
Results Success rate of vaginal delivery: 94.12% in the test group was significantly higher than the 73.53% in the control group (P <0.05); The first and second stages of labor: the test group were shorter than the control group (P <0.05); Complications: 5.88% of the test group was significantly lower than 26.47% of the control group, (P<0.05); SDS and SAS scores: After the intervention, Test group score as low as (33.18 ± 4.26) and (34.71 ± 5.02), The control group reached (46.73 ± 5.83) points and (47.31 ± 6.42) points, Data were lower (P <0.05).
Conclusion   Taking the free rotation of the fetal head in the second stage of labor can improve the success rate of vaginal delivery, shorten the labor process, reduce complications and improve the mentality. Safe and feasible, and conducive to promotion.