坐位分娩在第二产程应用的研究进展

doi:10.3969/j.issn.1674-490X.2020.06.010

摘要/Abstract

摘要： 对产妇在第二产程应用坐位分娩的相关研究进行综述,包括坐位分娩的具体方法及对母婴分娩结局的影响。与其他体位相比,坐位分娩有其特有的优势,助产士和产科医生可根据产妇的偏好和产程进展等因素综合决定是否在第二产程采用坐位分娩。

Abstract: This study reviewed the relevant studies on the application of the sitting position in the second stage of labour. It covered the implementation methods and the effects of the sitting position on maternal and neonatal outcomes. The advantages of sitting position are obvious compared with those of other type of birth positions. Midwives and obstetricians are recommended to perform the sitting position during the second stage of labour based on women's preferences and labour progress.

Key words: delivery, sitting position, mothers

中图分类号:

R473.71

臧瑜,蔡晓雪,李兆莹,王钰莹,刘秀芳. 坐位分娩在第二产程应用的研究进展[J]. 医学研究与教育, 2020, 37(6): 61-66.

参考文献

[1] 贾小燕, 漆洪波. WHO“产时管理改进分娩体验”关于第二、三产程的推荐建议[J]. 中国实用妇科与产科杂志, 2019, 35(5): 547-550. DOI: 10.19538/j.fk2019050113.
[2] World Health Organization. WHO Recommendations: intrapartum care for a positive childbirth experience[DB/OL]. Geneva:World Health Organization, 2018. [2020-09-10].https://www.who.int/reproductivehealth/publications/intrapartum-care-guidelines/en/.
[3] BARASINSKI C, DEBOST-LEGRAND A, LEMERY D, et al. Practices during the active second stage of labor: a survey of French midwives[J]. Midwifery, 2018, 60: 48-55. DOI: 10.1016/j.midw.2018.02.001.
[4] 刘爱英, 韩秋峪. 自由体位待产对头先露足月胎膜早破孕妇分娩结局的影响[J]. 医学理论与实践, 2018, 31(18): 2707-2709. DOI: 10.19381/j.issn.1001-7585.2018.18.006.
[5] SIMKIN P. Supportive care during labor: a guide for busy nurses[J]. J Obstet Gynecol Neonatal Nurs, 2002, 31(6): 721-732. DOI: 10.1177/0884217502239208.
[6] 颜华英, 孙香玲, 范如珍, 等. 孕妇生产过程中坐位体位指导的应用效果研究[J]. 中国现代医生, 2015, 53(6): 125-128.
[7] 唐静茹. 改良式坐位在第二产程中的应用[J]. 中国医药指南, 2014, 12(4): 88-89. DOI: 10.15912/j.cnki.gocm.2014.04.137.
[8] 孔亚利. 自由体位在初产妇镇痛分娩中的临床研究[D]. 南京: 南京中医药大学, 2017:16-17.
[9] 谢勤英, 马信华, 赖幼琳. 多功能分娩椅的设计及在产科中的应用[J]. 中国医学文摘(计划生育妇产科学), 2008(2): 87-89.
[10] THIES-LAGERGREN L, KVIST L J, SANDIN-BOJÖ A K, et al. Labour augmentation and fetal outcomes in relation to birth positions: a secondary analysis of an RCT evaluating birth seat births[J]. Midwifery, 2013, 29(4): 344-350. DOI: 10.1016/j.midw.2011.12.014.
[11] 李广隽, 付玉慧. 新产程标准模式下助产工作面临的问题与对策[J]. 中国妇幼保健, 2017, 32(16): 3713-3716. DOI: 10.7620/zgfybj.j.issn.1001-4411.2017.16.05.
[12] 肖青青, 高静, 赵霞, 等. 第二产程坐式分娩对产妇分娩效果的Meta分析[J]. 中国计划生育学杂志, 2017, 25(12): 812-819. DOI: 10.3969/j.issn.1004-8189.2017.12.003.
[13] 冯英, 杨柏财, 徐萍. 分娩球在COOK球囊引产中对分娩结局的影响[J]. 中华医学杂志, 2019, 99(25): 1972-1975. DOI: 10.3760/cma.j.issn.0376-2491.2019.25.014.
[14] 吴娜, 庄薇, 厉跃红. 分娩球配合自由体位助产的研究现状[J]. 护理学杂志, 2012, 27(16): 92-94. DOI: 10.3870/hlxzz.2012.16.092.
[15] 吴新媛. 利用分娩球促进自然分娩的研究现状[J]. 当代护士(下旬刊), 2016(3): 11-12.
[16] 程明清, 王宜芹, 王伟, 等. 分娩球跨坐用力应用于第二产程的效果观察[J]. 护理研究, 2013, 27(8): 727-728. DOI: 10.3969/j.issn.1009-6493.2013.08.024.
[17] WANG J F, LU X M, WANG C H, et al. The effectiveness of delivery ball use versus conventional nursing care during delivery of primiparae[J]. Pak J Med Sci, 2020, 36(3):550-554. DOI: 10.12669/pjms.36.3.1440.
[18] 李彩红, 李彩芬, 甘峻柠. 产程早期体位干预配合分娩辅助设施对分娩的影响[J]. 护理实践与研究, 2017, 14(11): 56-57. DOI: 10.3969/j.issn.1672-9676.2017.11.023.
[19] 孙海娟, 郑芙, 徐博. 分娩球配合自由体位助产对初产妇疼痛程度、产程及分娩结局的影响研究[J]. 中国社区医师, 2017, 33(8): 118-119. DOI: 10.3969/j.issn.1007-614x.2017.8.74.
[20] 喻莲香, 贾金平. 自由体位分娩在第二产程中的应用[J]. 国际医药卫生导报, 2015, 21(8): 1103-1105. DOI: 10.3760/cma.j.issn.1007-1245.2015.08.025.
[21] 胡静, 夏华安, 罗太珍, 等. 坐式分娩在第二产程中的应用[J]. 全科护理, 2018, 16(6): 702-704. DOI: 10.3969/j.issn.1674-4748.2018.06.026.
[22] DELIKTAS A, KUKULU K. A meta-analysis of the effect on maternal health of upright positions during the second stage of labour, without routine epidural analgesia[J]. J Adv Nurs, 2018, 74(2): 263-278. DOI: 10.1111/jan.13447.
[23] The Epidural and Position Trial Collaborative Group. Upright versus lying down position in second stage of labour in nulliparous women with low dose epidural: BUMPES randomised controlled trial[J]. BMJ, 2017: j4471. DOI: 10.1136/bmj.j4471.
[24] 林素青, 胡晓娜, 余丽珍. 第二产程初采用支撑式前倾坐位对分娩结局的影响[J]. 全科医学临床与教育, 2016, 14(5): 523-525. DOI: 10.13558/j.cnki.issn1672-3686.2016.05.013.
[25] 周肖郁, 叶小青, 黎佩兴, 等. 坐位分娩的临床效果观察[J]. 护理研究, 2010, 24(13): 1164-1165. DOI: 10.3969/j.issn.1009-6493.2010.13.017.
[26] 徐乔, 杨湘妹, 邱嵘. 上身直立或前倾位对巨大儿分娩的影响[J]. 护理研究, 2017, 31(30): 3898-3900. DOI: 10.3969/j.issn.1009-6493.2017.30.046.
[27] BOMFIM-HYPPÓLITO S. Influence of the position of the mother at delivery over some maternal and neonatal outcomes[J]. Int J Gynecol Obstet, 1998, 63: S67-S73. DOI: 10.1016/S0020-7292(98)00186-6.
[28] 徐朝霞, 岳红, 王明喜, 等. 自由体位分娩在头位难产待产妇中的应用[J]. 齐鲁护理杂志, 2017, 23(14): 126. DOI: 10.3969/j.issn.1006-7256.2017.14.064.
[29] 万筱婷, 邹小平, 敖英, 等. 不同分娩体位对分娩结局的影响[J]. 中国妇幼保健, 2009, 24(32): 4517-4518.
[30] 杨敏. 采取自由体位对头位已衔接的足月胎膜早破孕妇分娩结局的影响[J]. 护理实践与研究, 2018, 15(19): 72-74. DOI: 10.3969/j.issn.1672-9676.2018.19.031.
[31] 余金娣. 产妇产后出血的原因分析及护理[J]. 中国实用护理杂志, 2010, 26(18): 24-25. DOI: 10.3760/cma.j.issn.1672-7088.2010.06.100.
[32] 盛敏毅, 应豪, 段涛. 宫缩剂不敏感宫缩乏力性产后出血的诊治[J]. 实用妇产科杂志, 2013, 29(8): 564-565. DOI: 10.3969/j.issn.1003-6946.2013.08.002.
[33] 韩瑞华. 卡贝缩宫素在剖宫产术中预防产后出血的疗效观察[J]. 山西医药杂志, 2018, 47(6): 696-697. DOI: 10.3969/j.issn.0253-9926.2018.06.032.
[34] DE JONGE A, VAN DIEM M, SCHEEPERS P, et al. Increased blood loss in upright birthing positions originates from perineal damage[J]. BJOG: Int J Obstet Gynaecol, 2007, 114(3): 349-355. DOI: 10.1111/j.1471-0528.2006.01210.x.
[35] GUPTA J K, SOOD A, HOFMEYR G J, et al. Position in the second stage of labour for women without epidural anaesthesia[J]. Cochrane Database Syst Rev, 2017, 5: CD002006. DOI: 10.1002/14651858.cd002006.pub4.
[36] 金蕾, 曾洁, 潘丽, 等. 初产妇第二产程7种体位对母婴结局影响的网状Meta分析[J]. 护理学杂志, 2019, 34(15): 37-40. DOI: 10.3870/j.issn.1001-4152.2019.15.037.
[37] 臧瑜, 黄静, 陈海英, 等. 第二产程不同分娩体位应用现状及效果的研究进展[J]. 中国护理管理, 2019, 19(6): 946-951. DOI: 10.3969/j.issn.1672-1756.2019.06.030.
[38] ELVANDER C, AHLBERG M, THIES-LAGERGREN L, et al. Birth position and obstetric anal sphincter injury: a population-based study of 113 000 spontaneous births[J]. BMC Pregnancy Childbirth, 2015, 15: 252. DOI: 10.1186/s12884-015-0689-7.
[39] DAHLEN H G, DOWLING H, TRACY M, et al. Maternal and perinatal outcomes amongst low risk women giving birth in water compared to six birth positions on land.A descriptive cross sectional study in a birth centre over 12 years[J]. Midwifery, 2013,29(7):759-764. DOI: 10.1016/j.midw.2012.07.002.
[40] 彭海燕, 陈丽红, 曾丽丽, 等. 第二产程初产妇以分娩凳配合坐式用力的应用效果分析[J]. 临床护理杂志, 2018, 17(4): 31-33. DOI: 10.3969/j.issn.1671-8933.2018.04.012.
[41] 胡晓娜, 林素青, 余丽珍. 活跃晚期和第二产程初期支撑式前倾坐位对产妇分娩结局的影响[J]. 护理学杂志, 2016, 31(18): 49-51. DOI: 10.3870/j.issn.1001-4152.2016.18.049.
[42] 池琳琳, 张珊珊. 坐式分娩临床应用的研究进展[J]. 上海护理, 2014, 14(1): 56-59.
[43] ADACHI K, SHIMADA M, USUI A. The relationship between the parturient's positions and perceptions of labor pain intensity[J]. Nurs Res, 2003, 52(1): 47-51. DOI: 10.1097/00006199-200301000-00007.
[44] RAGNAR I, ALTMAN D, TYDÉN T, et al. Comparison of the maternal experience and duration of labour in two upright delivery positions: a randomised controlled trial[J]. BJOG, 2006, 113(2): 165-170. DOI: 10.1111/j.1471-0528.2005.00824.x.