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中国临床研究英文版:2025,38(1):122-125
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助产士主导的孕期体验分娩模式对初产妇妊娠结局的影响
(南京大学医学院附属鼓楼医院妇产医学中心,江苏 南京 210000)
Impact of midwife-led experience delivery mode on the pregnancy outcomes of primiparas
(Obstetrics and Gynecology Medical Center, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210000, China)
摘要
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Received:March 16, 2024   Published Online:January 20, 2025
中文摘要: 目的 探讨助产士主导的孕期体验分娩模式的临床实施及对初产妇妊娠结局的影响。 方法 选取2022年3月至12月南京鼓楼医院妇产医学中心建档定期产检至分娩孕妇的临床资料进行回顾性分析,其中参与孕期助产士主导的孕期体验分娩模式的119例孕妇为观察组,同期107例未参与者为对照组。两组孕妇建卡后至入院前均接受助产士门诊基本宣教并于36周前填写一般资料问卷、分娩认知调查表、分娩态度量表、孕妇焦虑量表及焦虑自评量表。观察组于36周后参与课程并再次填写相关量表,分析两组孕妇各量表的差异并比较两组孕妇分娩结局。 结果 观察组在分娩态度量表、孕妇焦虑量表及焦虑自评量表的得分均低于对照组,差异有统计学意义( P <0.01)。与对照组相比,观察组第二产程时长和产床上屏气时长更短( P <0.05),宫缩疼痛评分(5.77±1.31vs8.73±1.40,t =16.417,P <0.01)、剖宫产率(5.04%vs 21.50%,χ 2=13.636,P <0.01)及侧切率更低(8.40%vs 19.63%,χ 2=5.996,P =0.019),差异均有统计学意义。 结论 助产士门诊实施以助产士主导的集医疗、助产、母乳喂养及孕产康复专家指导为一体的孕期体验分娩模式可以帮助孕妇及家属提前熟悉产科环境、掌握入院指征流程、了解分娩全程、体验产床,有助增强阴道分娩信心,提升自然分娩率,保障母婴健康。
Abstract:Objective To explore the clinical implementation of a midwife-led pregnancy experience delivery mode and its influence on the pregnancy outcome of primiparas. Methods A retrospective analysis was conducted on pregnant women who had regular prenatal care and delivery at Obstetrics and Gynecology Medical Center in Nanjing Drum Tower Hospital from March to December 2022. One hundred and ninety nine women who participated in pregnancy experience deliveryl mode led by midwives during pregnancy were included in the observation group, while 107 women who did not participate during the same period were included in the control group. Both groups received pregnancy propaganda and education in the perinatal nursing clinic from the establishment of the card to the admission date, and filled in the general information questionnaire, the childbirth cognition questionnaire, the childbirth attitude questionnaire, pregnancy anxiety scale and self-rating anxiety scale before 36 weeks of gestation. The observation group participated in the course after 36 weeks and filled in the relevant scales again. The differences of each scale score and the delivery outcomes of the two groups of pregnant women were compared. Results The scores of the childbirth attitude questionnaire, pregnancy anxiety scale and self-rating anxiety scale were lower in the observation group than those in the control group ( P <0.01). Compared with the control group, the observation group had shorter second stage of labor time and length of breath holding time on the delivery bed ( P <0.05), lower uterine contraction pain scores (5.77±1.31 vs 8.73±1.40,t =16.417,P <0.01), cesarean delivery rate (5.04%vs 21.50%,χ 2=13.636,P <0.01) and lateral resection rate (8.40% vs 19.63%,χ 2=5.996,P =0.019). Conclusion The implementation of the team resource management mode led by midwives integrating medical treatment, midwifery, breastfeeding, and maternal rehabilitation experts in the perinatal care clinic through experiential childbirth simulation education classroom helps pregnant women and their families to familiarize with the obstetric environment beforehand, master the admission indication process, grasp the entire delivery procedure, and experience the delivery bed. This approach enhances confidence in vaginal delivery while improving natural birth rates and ensuring maternal and neonatal health.
文章编号:     中图分类号:R473.71    文献标志码:A
基金项目:江苏省“十四五”卫生健康科教能力提升工程〖CD*2〗妇产医学创新中心项目(苏卫科教〔2022〕11号-28);南京大学中国医院改革发展研究院基金项目(NJYGN2023049);南京鼓楼医院新技术发展基金项目(XJJFZJJ202037)
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