| Objective:1.To explore the effect of Dole's analgesic instrument on the pain and delivery outcomes of women undergoing vaginal pregnancy after cesarean section,and provide an effective reference for the wide application of Dole's analgesic instrument in clinical practice.2.Anatomical experience of vaginal childbirth in postpartum uterus using the Dole delivery analgesic instrument,paying attention to the inner feelings of the mother,deepening the understanding and thinking of the midwifery staff on the analgesia service of Doule delivery,to optimize the analgesia service of Doule delivery.To provide a reference for improving the delivery experience.Methods:1.Evaluation of the effect of the Dole labor analgesia instrument in vaginal delivery after cesarean section: choose December 1,2017-September 30,2019 in the obstetrics department of the First Hospital of Shanxi Medical University to perform vaginal trial after cesarean section The 100 women who met the inclusion criteria and voluntarily joined the study were the subjects of this study.They were divided into an observation group(n = 50)and a control group(n = 50)according to whether they received Dole 's labor analgesia.The women in the observation group used the Dole delivery analgesia when the labor progressed to the active stage,while the women in the control group refused to accept the Dole delivery analgesia.Both groups of women were given vaginaltrial delivery process monitoring and delivery guidance after cesarean section.The midwives who did not participate in the grouping and intervention of this study were responsible for recording the indicators of pain,delivery methods,transit cesarean section indicators,maternal and infant outcomes of the two groups of study subjects.Using SPSS22.0 statistical software,using t test,2 test,one-way analysis of variance,LSD test(with P <0.05 as the difference is statistically significant),to evaluate the Dole labor analgesia instrument for pregnancy vagina after cesarean section The impact of trial labor on maternal pain and delivery outcomes.2.Qualitative study on application of Doula delivery analgesia for vaginal delivery after cesarean section: a purpose sampling method was selected from October 1,2019 to November 30,2019 The postpartum vaginal delivery and the mother who received the Dole labor analgesia device conducted semi-structured interviews.The sample size was based on data saturation.A total of 12 women were interviewed.After the interview,the researchers transcribed the interview recording verbatim into sentences within 24 hours,using the Colaizzi method to organize and analyze the interview materials,and refine the topics.Results:1.Evaluation of the effect of Doule's analgesic instrument in vaginal delivery after cesarean section:(1)there was no statistical difference in baseline data between the two groups(P> 0.05);(2)evaluation of analgesic effect: before intervention There was no significant difference in VAS scores between the two groups(P> 0.05);after intervention for 30,60,and 120 minutes,the VAS scores of the observation group were lower than those of the control group(P <0.001);the VAS scores of the control group were higher than 120 minutes after the active period The differences at the other three time points were statistically significant(P <0.05).In the observation group,the VAS scores after30 min,60min,and 120 min intervention were lower than before the intervention,indicating that the intervention was effective;the VAS score after the 60 min interventionwas the lowest(P <0.001),indicating that the best analgesic effect was achieved at the60 min intervention;(3)delivery methods and Comparison of indications for transit to cesarean section: 79 cases of women who underwent VBAC in the two groups and 21 cases of VBAC failed to undergo cesarean section,of which 5 cases in the observation group and 16 cases in the control group.The cesarean delivery rate in the observation group was significantly lower than that in the control group.(P<0.05);due to "social factors",the proportion of women who switched to cesarean section was significantly lower in the observation group than in the control group(P<0.05),and there were no significant differences in other indications for cesarean section(P>0.05);(4)Comparison of maternal and infant outcomes: Comparing the women who completed VBAC in the two groups,the observation group significantly shortened the active period of the first stage of labor and reduced the amount of postpartum hemorrhage(both P <0.001).There was no difference in the Apgar score of the newborns(P>0.05);(5)Comparison of maternal adverse reactions: Compared with the two women who completed VBAC,there was 1 case of pruritus in the observation group and no adverse reactions in the control group.There was no statistical difference.Learning intention(P>0.05);(6)Comparison of lactation volume and lactation time: Comparing the women who completed VBAC in the two groups,there was no statistical difference in lactation onset time and lactation volume adequacy rate(P>0.05),indicating that Dole gave birth analgesia No effect on breast milk secretion.2.After cesarean delivery,there are four main aspects of the real experience of using a Doule delivery analgesia instrument in the labor process: relieving pain,gaining social support,improving self-efficacy during delivery,and hoping for more guidance on delivery analgesia Conclusion:1.The use of the Dole delivery analgesia instrument for women who have a vaginal trial after cesarean section can effectively relieve the pain of childbirth,improve theself-efficacy of childbirth,promote the progress of the labor process,reduce the amount of postpartum hemorrhage,increase the natural delivery rate,and ensure the safety of mothers and infants.It is worth further promotion.2.Obstetric workers should pay attention to the inner feelings of the women,give more humane care,continuously optimize the labor analgesia service,and improve the labor experience.Attention should also be paid to the popularization of labor analgesia knowledge,these measures are of great significance to the clinical promotion of Daorle labor analgesia services. |
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