新疆医科大学学报

目的研究导乐分娩形式对初产妇分娩及产后心理状态的影响。方法选择在我院产科门诊建卡并定期在我院做产前检查的初产妇600例,在临产前1²周测定其SAS、SDS分数,在均衡年龄、文化程度、家庭月收入、有无人员照顾及心理干预前SAS、SDS分数等基线资料的基础上随机分为导乐分娩组(300例)和对照组(300例),导乐分娩组采取导乐分娩,对照组采用常规分娩,观察和比较两组间剖宫产率、出血量、新生儿阿氏评分≤7分的发生率及产后抑郁、焦虑情绪的发生情况。结果与对照组相比,导乐分娩组患者的剖宫产率以及第一、第二、第三产程时间、产时及产后2 h出血量减少(P<0.05);导乐分娩组分娩的新生儿阿氏评分≤7分的发生率低于对照组(P<0.05);导乐分娩组产妇的焦虑、抑郁情绪发生率及产后SAS、SDS分数低于对照组(P<0.05)。结论导乐分娩降低了产妇焦虑、抑郁情绪,降低剖宫产率,减少了产后出血,降低了新生儿窒息发生率,是目前临床上安全的、值得推广的分娩方式。

Objective To study the effects of doula delivery to parturition and postpartum mentality in primipara.Methods In this case-control study,we recruited 600 primipara as subjects,all primipara were built care card and done prenatal examination in our hospital regularly.All primipara were divided into two groups(300 in case groups and 300 in control groups) in random.Before parturition,SAS and SDS score were measured.The SAS score,SDS score,ages,educational level,family income,lack of care were balanced between two groups at beginning.The case group takes doula delivery and the control group takes conventional delivery.Then observed the cesarean section rate,blood loss,neonatal Apgar score ≤ 7,and the incidence of postpartum depression and anxiety between the two groups.Results Compared with the control group,the cesarean section rate and the blood loss of the first,second,third stage of labor,intrapartum and postpartum in case group were decreased(P<0.05).The incidence of neonatal Apgar score ≤7 was lower in case group than control group(P<0.05).The incidence of postpartum depression and anxiety,the postpartum SAS and SDS score was lower in case group compared with the control group(P<0.05).Conclusion Doula delivery lower the incidence of postpartum anxiety and depression,the cesarean section rate,the incidence of neonatal asphyxia,postpartum bleeding.It is a safe mode of delivery.