The Application Of Free Posture In The Second Stage Of Labor In Painless Childbirth

Objective:To discuss the effects of free posture on the duration of the second stage of labor and the delivery quality,by comparing with the free posture and the traditional posture in painless labor of primipara.Methods: 200 primipara who were hospitalized during January 2015 to December 2015 in Xingtai People's Hospital were selected.The study subjects were randomly divided into control group and observation group.Intraspinal anesthesia was used after the uterine orifice opened for 3cm.Traditional lithotomy posture was used for the control group.The free posture was used for observation group.Under the guidance of the medical staff,the primipara in the observation group can adopt a comfortable posture according to their preferences,such as: semi reclining position,side lying,sitting,squatting position,knee chest decubitus etc.The case is excluded,if the parturient women can not take free posture.Differences in the duration of the second stage of labor,abnormal rate of fetal heart rate,postpartum hemorrhage volume,perineal resection rate,forceps delivery rate and cesarean section rate were compared.Statistics : SPSS17.0 software was used for statistical analysis.Differences of measurement data and enumeration data were compared with t-test and ?2 test.P<0.05 was statistically significant.Result:1 The mean time of the duration of the second stage of labor in the observation group is 45.21 min,while it is 62.59 min in the control group.The duration of the second stage of labor in the observation group is significantly less than that of the control group.The difference is statistically significant(t=11.233,P = 0.001).2 Occurrences of abnormal fetal heart rate in the observation group were 31,and 45 in the control group.The incidence rate of abnormal fetal heart rate in the two groups was 31.63% and 45.00%,respectively.The improved average time of the fetal heart rate abnormalities was 46.32 s and 59.71 s,respectively.The improvement rate of abnormal fetal heart rate was 96.77% and 93.33%,respectively.The incidence rate of abnormal heart rate in the observation group was significantly lower than that in the control group(X2=4.16,P=0.041).And after the occurrence of abnormal fetal heart rate,the utility of free posture can effectively improve the rate of fetal heart rate(X2=4.031,P=0.045).The consumption of time for the improvement in the observation group is significantly shorter than the control group.The differences are statistically significant(t=5.957,P=0.001).3 Postpartum 2 hours average vaginal bleeding amount in the observation group is 195.52 ml,compared with 202.29 ml in the control group.The vaginal bleeding amount in the free posture group is less than that in the traditional position group,but the difference is not statistically significant(t=1.51,P=0.133)?4 In the 98 cases of the observation group,there are 9 cases of perineal resection,2 cases of forceps delivery,1 cases of termination of pregnancy in cesarean section.In the 100 cases of the control group,there are 19 cases of perineal resection,9 cases of forceps delivery,3 cases of termination of pregnancy in cesarean section.The rate of perineal resection was 9.18% in observation group and 19.00% in control group.The rate of forceps delivery was 2.04% in observation group and 9.00% in control group.The cesarean section rate of the observation group was 1.02%,and it was 3.00% of the control group.The lateral episiotomy rate(X2=3.928,P=0.047),forceps delivery rate(X2=4.714,P=0.03)and the cesarean section rate(X2=4.688,P=0.028)of the observation group was lower than that of the control group.Differences were statistically significant.Conclusion:The implication of free posture for the primipara in painless childbirth,such as semi reclining position,side lying,sitting,squatting position,knee chest decubitus etc.,can reduce the time of the second stage of labor,fetal distress rate,forceps delivery rate and the cesarean section rate.However,it is not clear whether the application of free posture can reduce postpartum hemorrhage,and the further research of larger sample cases is suggested.