The Effects On The Pregnant Outcomes Of Psychology Building With Artificial Rupture Of Membrane And Doula Ball Dealing With Delivery

Objective: The study aims to evaluate the effects of psychology building on the pregnant outcomes and postnatal anxiety and depression. After the treatment of psychology building, the normal, full-term, and cephalic presentation pregnant women with singleton received treatment of Doula ball and artificial rupture of membrane during different timing of active phase of the second stage of labor for vaginal delivery. We try to discover whether such management would have impact on the length of labor, modes of delivery, blood loss two hours postpartum, fetal status, and complications of neonates and mothers. In such way, we are going to invest a safer, more reasonable and more effective model for the management of pregnancy and dealing of labor. Method: This study was a prospective trial. Totally 1,768 cases of pregnant women followed in the obstetric outpatient clinics of the First Hospital of Xinjiang Medical University were included and assigned randomly as study group A and control group A. Cases in the study group A(n=873) received psychology building and routine prenatal care. Cases in the control group A(n=895) only received routine care. Between two groups following adverse events were compared: pre-eclampsia, gestational diabetes, polyhydramnios, macrosomia, fetal growth restriction, preterm labor, modes of delivery, anxiety, and depression. In study group A, all the other cases suitable for vaginal delivery without any complications and abnormal ultrasound findings(n=651) were again randomly assigned into two groups: study group B and control group B. In study group B(n=321), mothers received Doula ball treatment and non-recumbent position, when the cervix dilated into 3-4cm, they got the artificial rupture of membrane and lateral position with fetal heart rate monitoring. When the fetal head engaged, mothers again received Doula ball and non-recumbent position. In control group B(n=329), mothers received Doula ball treatment and non-recumbent position, when the cervix dilated into 5-9cm, they got the artificial rupture of membrane and lateral position with fetal heart rate monitoring. When the fetal head engaged, mothers again received Doula ball and non-recumbent position. Between study group B and control group B, duration of labor, modes of delivery, causes for cesarean section, postpartum hemorrhage, fetal status intrauterine and complications of neonates and mothers were compared. Results: Between study group A and control group A, there were no significant differences in age, pregnant weeks, education level, economic situation(all P>0.05). There were significant differences about body weigh increase during pregnancy, incidences of pre-eclampsia, gestational diabetes, polyhydramnios, macrosomia, fetal growth restriction and scores for postpartum anxiety and depression(all P<0.05). For preterm delivery, there was no difference(P>0.05); and for the rate of cesarean section, there was significant difference(P<0.05). Between study group B and control group B, there were no significant differences about age, body weight increase during pregnancy, parity, pregnant weeks, body weight of birth(all P>0.05). No mother received any vaginal assisted delivery. There was more cesarean section in the control group B(P<0.05). For mothers of vaginal delivery, there were shorter duration of labor, shorter first stage of labor, fewer two-hour postpartum hemorrhage in the study group B than in the control group B(all P<0.05). There were no differences about the second and the third stage of labor(all P>0.05). As for the causes of cesarean section, there were more malposition of fetal head, suspended fetal presentation descending and fetal distress in the control group B(all P<0.05). There were more contamination of amniotic fluid in the control group B than in the study group B, especial for the II degree and III degree contamination. In the study group B, there were higher Apgar scores in 1 minute and in 5 minute than in the control group B(all P<0.05). There were no significant differences about recessive prolapse of umbilical cord, fetal distress, neonatal asphyxia, neonatal scalp edema and scalp hematoma(all P>0.05). As for complications, there were more uterine atony, postpartum hemorrhage, puerperal infection, soft birth canal laceration and urine retention in the control group B than in the study group B(all P<0.05). Conclusion: Psychology building is effective for the reasonable control of body weight during pregnancy, and could decrease the risks of pre-eclampsia, gestational diabetes, poluhydramnios, macrosomia, fetal growth restriction and postpartum anxiety and depression, but couldn’t prevent preterm delivery. Psychology building with the treatment of Doula ball during the labor and artificial rupture of membrane during the active phase in the first stage of labor could increase the rate of vaginal delivery and Apgar scores of neonates, shorten the first stage of labor and decrease adverse events such as: postpartum hemorrhage, complications of mothers, contamination of amniotic fluid and cesarean section for the causes of abnormal fetal presentation, suspended fetal presentation descending and fetal distress, and wouldn’t increase incidences of recessive prolapse of umbilical cord, fetal distress, neonatal asphyxia, neonatal scalp edema and scalp hematoma.