产妇姿势和认知行为干预对胎头位置异常的初产妇分娩结果的影响:随机对照临床试验。

IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Xiaofeng Wan, Jinguo Zhai, Xiaoqin Lu, Xiuhong Wang, Hamza Saidi Lilenga, Mei Luo, Xiaochun Wang, Xueyan Wang, Yanli Zhou
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引用次数: 0

摘要

目的:胎儿头位不正可导致新生儿和产妇并发症。胎儿头位不正经常发生在分娩过程中。需要及时采取适当的处理措施。产妇姿势和认知行为干预可改善胎头不正初产妇的分娩结局:方法:一项随机对照临床试验于 2022 年 1 月至 12 月进行(中国临床试验注册中心,ChiCTR2100049359)。符合条件的初产妇被随机分为四组。A 组接受传统的围产期保健。B、C和D组除接受传统围产期保健外,还分别接受体位管理、体位管理与音乐疗法、体位管理与视频教育。孕产妇体位指的是将孕妇置于特定的体位(侧卧位、侧俯卧位、手膝位、开膝胸位),以改变骨盆的解剖结构,从而促进胎儿向下运动和分娩。对产妇和新生儿的结局进行了记录和比较:共纳入 136 名初产妇,A、B、C 和 D 组分别有 34、35、34 和 33 名产妇。B 组、C 组和 D 组的剖宫产发生率低于 A 组(5.7%、2.9% 和 3.0% 对 20.6%,p p p 结论:初产妇可能会出现胎儿头位不正。分娩过程中的产妇姿势管理和认知行为干预可改善胎头不正初产妇的分娩结局。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of maternal posture and cognitive-behavioral interventions on labor outcomes in primigravidas with abnormal fetal head position: a randomized controlled clinical trial.

Objective: Fetal head malposition can result in neonatal and maternal complications. Fetal head malposition occurs frequently in labor. Appropriate and timely managements are required. Maternal posture and cognitive-behavioral interventions could improve labor outcomes in primigravidas with fetal head malposition.

Methods: A randomized controlled clinical trial was performed between January and December 2022 (Chinese Clinical Trial Registry, ChiCTR2100049359). Eligible primigravidas were randomly assigned into four groups. Group A received traditional perinatal care. Group B, C, and D received posture management, posture management with music therapy, and posture management with video education, respectively, in addition to traditional perinatal care. The maternal postures referred to place pregnant women in certain positions (lateral, lateral-prone, hands and knees, open knee-chest) to change the anatomical structure of pelvis, thus, to facilitate the fetal downward movement and birth. Maternal and neonatal outcomes were recorded and compared.

Results: A total of 136 primigravidas were included, with 34, 35, 34, and 33 women in group A, B, C, and D, respectively. The incidences of cesarean section were lower in groups B, C, and D than that in group A (5.7%, 2.9%, and 3.0% versus 20.6%, p < 0.05). The fetal position correction rates at the time of full dilation of cervix were higher in groups B, C, and D than that in group A (66.7%, 63.6%, 68.8% versus 27.6%, p < 0.05). Primigravidas in groups B, C, and D had better experiences and a lower anxiety level than those in group A (p < 0.001). The four groups had no statistically significant differences in the total labor duration, operative vaginal delivery, umbilical artery blood pH, and neonatal Apgar scores.

Conclusion: Fetal head malposition could happen in primigravidas. Maternal posture management and cognitive-behavioral interventions during labor could improve labor outcomes in primigravidas with fetal head malposition.

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来源期刊
CiteScore
4.40
自引率
0.00%
发文量
217
审稿时长
2-3 weeks
期刊介绍: The official journal of The European Association of Perinatal Medicine, The Federation of Asia and Oceania Perinatal Societies and The International Society of Perinatal Obstetricians. The journal publishes a wide range of peer-reviewed research on the obstetric, medical, genetic, mental health and surgical complications of pregnancy and their effects on the mother, fetus and neonate. Research on audit, evaluation and clinical care in maternal-fetal and perinatal medicine is also featured.
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