水中待产分娩对初产妇产后近期盆底功能 及新生儿安全性的影响

Effect of water delivery on recent postpartum pelvic floor function and neonatal safety

摘要:

目的 探讨水中待产分娩对初产妇产后近期盆底功能及新生儿安全性的影响。方法 选取2014 年 11 月-2017 年3 月杭州市妇产科医院收治的初产妇200 例为研究对象，根据产妇意愿分为两组，分别给予水 中待产分娩（观察组80 例）及常规待产分娩（对照组120 例），对比其生产结束后盆底功能指标差异，统计 两组新生儿情况。结果 观察组与对照组产后42 d 压力性尿失禁（SUI）发生率、盆腔器官脱垂（POP）发 生率比较，差异有统计学意义（P <0.05）。观察组盆底组织Ⅰ类肌纤维肌力0、Ⅱ、Ⅲ和Ⅴ级与对照组比较， 差异有统计学意义（P <0.05）。Ⅱ类肌纤维肌力0、Ⅱ和Ⅴ级与对照组比较，差异有统计学意义（P <0.05）。 观察组和对照组新生儿窒息率、感染率比较，差异无统计学意义（P >0.05）。观察组和对照组盆底肌肌电、 盆底肌压力比较，差异有统计学意义（P <0.05）。结论 水中待产分娩能够有效减轻初产妇产后近期盆底电生 理指标的损伤情况，对产妇产后近期盆底功能影响较小，且新生儿安全性较好，不会增加新生儿窒息率和感染 率，建议在临床上推广。

Abstract:

Objective To observe the effect of in-water childbirth on postpartum pelvic floor function and recent neonatal safety in primiparas. Methods Totally 200 primiparas in our hospital between November 2014 and March 2017 were selected as the research objects, and divided into 2 groups. They were given expectant water delivery (80 cases in the observation group) and conventional labor delivery (120 cases in the control group). The pelvic floor function indexes after delivery were compared between the 2 groups and the neonatal situations were statistically analyzed. Results There were significant differences in the incidences of stress urinary incontinence (SUI) and pelvic organ prolapse (POP) between the observation group and the control group 42 d after delivery (P < 0.05). The grade 0, II , III and V muscular strength of class I muscle fibers in the pelvic floor of the observation group was significantly different from that of the control group (P < 0.05); and the grade 0, II and V muscular strength of class II muscle fibers in the pelvic floor of the observation group was significantly different from that of the control group (P < 0.05). There was no significant difference in the neonatal asphyxia rate or infection rate between the observation group and the control group (P > 0.05). There were significant differences in pelvic floor muscle EMG and pelvic floor muscle pressure between the observation group and the control group (P < 0.05). Conclusions Delivery in water can effectively alleviate the damage of pelvic floor electrophysiological indexes in the early postpartum period of primipara and has little effect on postpartum pelvic floor function, moreover it does not increase the neonatal asphyxia rate or infection rate, therefore the neonatal safety is good. It is recommended in clinical practice.