摘要
Abstract
Objective To compare delivery and neonatal outcomes of artificial membrane rupture and natural membrane rupture under free position for laboring,and seek for more effective labor management model.Methods A retrospective analysis was conducted on 170 parturient women in our hospital from June 2014 to July 2015.They were divided into artificial membrane rupture group (85 cases) and natural membrane rupture group (85 cases) according to membrane rupture ways.The artificial membrane rupture group was given artificial rupture in active period combined with free position for laboring,the natural membrane rupture group adopted free position for laboring and waited for natural rupture of membrane.The maternal birth outcomes and neonatal outcomes of the two groups were noted and compared.Results The cesarean section rate of the artificial membrane rupture group (22.4％) was significantly higher than that of the natural membrane rupture group (9.6％) due to abnormal occiput position and intrauterine fetal distress (P ＜ 0.05).The first stage of labor [(537.8 ± 50.3) min] and the second stage of labor [(35.8 ± 9.1) min] were shorter,and 2-h postpartum hemorrhage volume [(182.4 ± 37.5) ml] was smaller in the artificial rupture group compared to the natural rupture group [(549.5 ± 57.3) min,(38.5 ± 10.5) min,and (190.7-± 40.4) ml respectively];and the rates of cervix laceration (4.5％),cervical edema (4.5％),puerperal infection (1.5％) and urinary retention (6.1％) were slightly higher than those of the natural rupture group (3.9％,2.6％,0.0％ and 3.9％ respectively),the differences had no statistical significance (P ＞ 0.05).The 1-min Apgar score (7.92 ± 0.97) and the occurrence rate of caput succedaneum (21.2％) in the artificial rupture group were slightly higher than those in the natural membrane rupture group [(7.77 ± 0.99) and 14.3％ respectively],and the neonatal asphyxia rate (7.6％) was slightly lower than that in the natural membrane rupture group (10.4％),the differences were not statistically significant (P ＞ 0.05).Conclusions Under free position for labor,compared with natural rupture,artificial membrane rupture does not significantly reduce labor time,but increases cesarean section rate due to abnormal occiput position and intrauterine fetal distress.It is suggested that it is better not to use artificial membrane rupture during active period in order to avoid disturbing normal laboring process.关键词
人工破膜/自然破膜/自由体位待产/妊娠结局/Apgar评分Key words
artificial membrane rupture/natural membrane rupture/free position for laboring/pregnancy outcome/Apgar score分类
医药卫生
