| Objective: to evaluate the effects of three maternal positions(prone position?supine position?lateral position)on perinatal outcomes during second stage of labor, like The rate of the vaginal delivery?episiotomies?perineal lacerations?fetal heart rate patterns and neonatal asphyxia?women's VAS scales?PRI?S scales?PRI scales?PPI scales?VAS?A scales and so on.Methods: this trial included 180 primipara deliveried in the Hospital between December 2014 and May 2015 were divided into the three groups: lateral position group?prone position group and supine position group.Each group includes 60 cases.Encouraged mothers to choose free position(walking, sitting, lying, standing, squatting, kneeling lying position) during labor,the maternal choosed the lateral?prone or supine position during delivery. The pregnancy outcomes?labour pain and anxiety?fetal heart rate patterns?the risk of neonatal asphyxia in three groups were compared.This research through the ethicscommittee approval,all women are signed informed consent. Application of SPSS 18.0 statistical software,Maternal and neonatal outcomes were compared with the use of chi?squared,Fisher exact test,Kruskal?Wallis rank sum test,an a probability value of 0.05 was used to indicate statistical significance.Results: 1 The comparison of three groups of maternal pregnancy outcome 1.1 The comparison of three groups of maternal cesarean section rate and vaginal delivery rate,there have statistical differences(P<0.05).prone position group's vaginal delivery rate(98.33%)was higher than supine position group's(85.00%),there have statistical differences(?2 =8.539,P=0.003); lateral position group's vaginal delivery rate(96.67%)was higher than supine position group's(85.00%),there have statistical differences(?2=5.783,P=0.011); prone position group's vaginal delivery rate compared with lateral position group's,there have no statistical differences(P>0.0125).Prone position group's,cesarean section rate(0.00%)was lower than supine position group's(0.10%),lateral position group's cesarean section rate(0.00%)was lower than supine position group's(0.10%),there have statistical differences(P<0.0125). prone position group's cesarean section rate compared with lateral position group's, there have no statistical differences(P>0.0125). The comparison of three groups of the rate of operative vaginal delivery,there have no statistical differences(P>0.0125). 1.2 The comparison of three groups of episiotomy rate,the rate of the first degree perineal lacerations and the rate of perineal edema,there have statistical differences(P<0.05).Prone position group of episiotomy rate(5.08%)was lower than supine position group's(25.49%),there have statistical differences(?2=10.568,P<0.001);lateral position group of episiotomy rate(3.45%)was lower than supine position group's(25.49%),there have statistical differences(?2=12.810,P<0.001); prone position group of episiotomy rate compared with lateral position group's,there have no statistical differences(P>0.0125).Prone position group of the rate of the first degree perineal lacerations(83.05%)is higher than supine position group's(49.02%),there have statistical differences(?2=13.713,P<0.001); lateral pos? ition group of the rate of the first degree perineal lacerations(82.76%) is higher than supine position group's(49.02%),there have statistical differences(?2 =13.512,P<0.001); prone position group of the rate of the first degree perineal lacerations compared with lateral position group's,there have no statistical differences(P>0.0125).Prone position group of the rate of perineal edema(10.17%) is lower than supine position group's(21.57%),there have no statistical differences(?2 =1.713,P=0.191); lateral position group of the rate of perineal edema(13.79%) is lower than supine position group's(21.57%),there have no statistical differences(?2 =0.563,P=0.453); prone position group of the rate of perineal edema compared with lateral position group's,there have no statistical differences(?2 =0.323,P>0.0125).The comparison of three groups of the rate of the second degree perineal lacerations,there have no statistical differences(P>0.0125).Three groups were no intact perineum,third or fourth degree perineal lacerations. 1.3 The comparison of three groups of the blood lose after 2 hours of labor and duration of second stage of labor,there have no statistical differences(P>0.05). 2 The comparison of three groups of Women's labour pain and anxiety The comparison of three groups of Women's VAS scales?PRI?S scales?PRI?A scales?PRI scales ? PPI scales ? VAS?A scales,therehave statistical differences(P<0.05).Women's VAS scales?PRI?S scales?PRI scales?PPI scales, VAS?A scales were higher in the group of supine position(P< 0.05), PRI?A scales in the group of supine position was were higher than the group of lateral position( P<0.05). Women's PRI?A scales in the group of supine position was were higher than the group of lateral position( P< 0.05). 3 The comparison of three groups of fetal heart rate patterns and the risk of neonatal asphyxiaThe comparison of three groups of normal fetal heart rate patterns and early deceleration,there have statistical differences(P<0.05).Prone position group of normal fetal heart rate patterns(83.05%)was higher than supine position group's(50.98%),there have statistical differences(?2 =11.533,P< 0.001);lateral position group of normal fetal heart rate patterns(86.21%)was higher than supine position group's(50.98%),there have statistical differences(?2 =14.328,P<0.001); prone position group of normal fetal heart rate patterns compared with lateral position group's,there have no statistical differences(P>0.0125).The comparison of three groups of early deceleration, variable deceleration?late deceleration?tachycardia and the risk of neonatal asphyxia,there have no statistical differences(P>0.0125).Conclusions: prone position delivery and lateral position delivery to improve the delivery of maternal and neonatal outcomes in the second stage of labor,they are safe and effective method and they have clinical application value. |
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