Comparison of the application of lateral position and lithotomy position in the second stage of labor nursing of full-term primiparas
DING Weiwei XUE Mei LU Yunbo▲
Department of Obstetrics, the First Affiliated Hospital of Nanjing Medical University Jiangsu Provincial People’s Hospital, Jiangsu Province, Nanjing 210029, China
Abstract:Objective To compare the application effect of lateral position and lithotomy position in the second stage of labor nursing for full-term primiparas, to guide the nursing intervention for the second stage of labor for full-term primiparas. Methods From April 2018 to April 2020, 120 full-term primiparas in the First Affiliated Hospital of Nanjing Medical University were selected as the research objects. They were divided into observation group (60 cases) and control group (60 cases) by random number table method. Observation group was used the lateral position during the second stage of labor, and control group was used the lithotomy position during the second stage of labor. The duration of the second stage of labor, the vaginal delivery rate, the perineal pain degree (visual analogue scale [VAS] assessment) at 2, 4, 8 h after delivery, and the incidence of perineal injury and perineal lateral resection between two groups were compared. Results The second stage of labor in observation group was shorter than that in the control group, and the vaginal delivery rate was lower than that in control group, and the differences were significant statistically (all P < 0.05). VAS score at 8 h after delivery was lower than that at 2, 4 h after delivery, VAS score at 4 h after delivery was lower than that at 2 h after delivery; VAS scores of observation group at each time point were lower than those of the control group, and the differences were significant statistically (all P < 0.05). The incidence of perineal injury and perineal lateral resection in observation group were lower than those in control group, and the differences were significant statistically (all P < 0.05). Conclusion The use of lateral position in the second stage of labor for full-term primiparas are beneficial to shorten the second stage of labor, effectively reduce vaginal delivery, and reduce the degree of perineal pain, perineal injury and perineal lateral resection.
丁炜炜 薛美 陆云波▲. 侧卧位与截石位在足月初产妇第二产程护理中的应用比较[J]. 中国医药导报, 2021, 18(15): 129-132.
DING Weiwei XUE Mei LU Yunbo▲. Comparison of the application of lateral position and lithotomy position in the second stage of labor nursing of full-term primiparas. 中国医药导报, 2021, 18(15): 129-132.
[1] 张为远,侯磊.中国大陆剖宫产状况大数据调查的启示[J].中国实用妇科与产科杂志,2018,34(1):38-40.
[2] 冉秀文,官婵婵,徐思思,等.自由体位配合无创接生对初产妇分娩结局的影响[J].中国医药导报,2020,17(3):94-97.
[3] Desseauve D,Fradet L,Lacouture P,et al. Position for labor and birth:State of knowledge and biomechanical perspectives [J]. Eur J Obstet Gynecol Reprod Biol,2017, 208:46-54.
[4] 米丽邦古丽·吾布里,马瑛,丁桂凤.自由体位分娩联合自然娩肩法对妊娠结局和产妇产后恢复的影响[J].中国医药导报,2018,15(29):66-69,78.
[5] Paternotte J,Potin J,Diguisto C,et al. Delivery in lateral position.Comparative study in low risk pregnancy between lateral and dorsal position for the delivery in eutocic vaginal birth [J]. Gynecol Obstet Fertil,2012,40(5):279-283.
[6] 赵海艳,于雪娟,董慧,等.自由体位助产联合分娩球运动在初产妇足月分娩中的应用价值[J].河北医药,2019, 41(22):3518-3520.
[7] Heller GZ,Manuguerra M,Chow R. How to analyze the Visual Analogue Scale:Myths,truths and clinical relevance [J]. Scand J Pain,2016,13:67-75.
[8] 任雪琼.自由体位分娩与传统体位分娩对初产妇产程分娩方式及母婴结局的影响[J].浙江临床医学,2017,19(11):2016-2018.
[9] Walker KF,Kibuka M,Thornton JG,et al. Maternal position in the second stage of labour for women with epidural anaesthesia [J]. Cochrane Database Syst Rev,2018,11(11):CD008070.
[10] 吕海荣,刘葵,刘晶.自由体位分娩对初产妇分娩结局的影响研究[J].中国计划生育和妇产科,2018,10(5):77-80.
[11] 夏华安,江紫妍,胡静,等.第二产程不同体位娩出胎儿的临床应用效果[J].中国计划生育和妇产科,2019,11(1):41-44,52.
[12] Lawrence A,Lewis L,Hofmeyr GJ,et al. Maternal positions and mobility during first stage labour [J]. Cochrane Database Syst Rev,2013(10):CD003934.
[13] 张丽玲,申灵芝,陈燕丽.侧卧位分娩对产程及妊娠结局的影响[J].中国妇幼保健,2018,33(16):3683-368.
[14] 田文纯,钟序素.侧卧位分娩在阴道分娩中的应用[J].护理实践与研究,2016,13(18):70-71.
[15] Dresang LT,Yonke N. Management of Spontaneous Vaginal Delivery [J]. Am Fam Physician,2015,92(3):202-208.
[16] 何海燕,刘宏.侧卧位在产妇第二产程中应用的安全性及可行性研究[J].护理管理杂志,2017,17(2):146-147.
[17] Dennis AT,Hardy L,Leeton L. The prone position in healthy pregnant women and in women with preeclampsia-a pilot study [J]. BMC Pregnancy Childbirth,2018, 18(1):445.
[18] 冯惠华.不同体位护理在持续性枕横位和枕后位高龄产妇足月妊娠分娩中的应用效果[J].护理实践与研究,2020,17(9):75-78.
[19] 魏琳娜,时元菊,王雪燕.第二产程采取侧卧位分娩对母婴围生期结局的影响[J].重庆医学,2017,46(31):4460-4463.
[20] Zhang H,Huang S,Guo X,et al. A randomised controlled trial in comparing maternal and neonatal outcomes between hands-and-knees delivery position and supine position in China [J]. Midwifery,2017,50:117-124.
[21] 韩翠存,姜梅.侧卧位接产在第二产程中的应用效果[J].中华现代护理杂志,2015,21(30):3608-3610.
[22] Le Ray C,Lepleux F,De La Calle A,et al. Lateral asymmetric decubitus position for the rotation of occipito-posterior positions:multicenter randomized controlled trial EVADELA [J]. Am J Obstet Gynecol,2016,215(4):511.e1-7.
[23] 王雪霞,徐萍.侧卧位分娩配合无创接生对产妇和新生儿的影响[J].国际护理学杂志,2018,37(14):1930-1932.
[24] Puapornpong P,Raungrongmorakot K,Laosooksathit W,et al. Comparison of Breastfeeding Outcomes Between Using the Laid-Back and Side-Lying Breastfeeding Positions in Mothers Delivering by Cesarean Section:A Randomized Controlled Trial [J]. Breastfeed Med,2017,12:233-237.
[25] 龙良平,林莹.侧卧位分娩对母婴结局影响的荟萃分析[J].护理学杂志,2018,33(31):96-100.
[26] 柯莹,黄仁英,肖文萍.侧卧位自发用力对硬膜外分娩镇痛初产妇第二产程与分娩结局的影响[J].中国当代医药,2020,27(25):118-120.