Influence of the upright position delivery in the second stage of labour on delivery outcomes in primiparas
10.3760/cma.j.cn211501-20230129-00197
- VernacularTitle:初产妇第二产程直立位分娩对分娩结局的影响
- Author:
Tao WEI
1
;
Yufei XIE
;
Dehui WANG
Author Information
1. 北京医院产科国家老年医学中心中国医学科学院老年医学研究院，北京 100730
- Keywords:
Second labour stage;
Primiparas;
Upright position;
Pharmacologic analgesia
- From:
Chinese Journal of Practical Nursing
2023;39(16):1212-1216
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the influence of the upright position delivery in the second stage of labour on delivery outcomes in primiparas, so as to provide reference for the formation of systematic delivery management strategies.Methods:This study was a cohort study, 454 primiparas who delivered in Beijing Hospital from January 2022 to December 2022 were selected. In the second stage of labour, according to the willingness of the primiparas, they were divided into the upright group(delivered in upright position, 222 cases) and the supine group(delivered in supine position, 232 cases). The duration of the second stage of labour, perineal injury, vaginal midwifery, neonatal asphyxia, and the effect of pharmacological analgesia on delivery outcomes in two groups of primiparas were observed and compared.Results:The duration of the second stage of labour was 30 (22, 50) min in the upright group, which was shorter than 48 (30, 80) min in the supine group, with statistically significant difference ( Z=-5.90, P < 0.05). The rate of lateral episiotomy was 17.6% (39/222) in the upright group, which was lower than 28.0% (65/232) in the supine group, with statistically significant difference ( χ2=7.02, P <0.05). There was no significant difference in the incidence of second degree perineal injury, vaginal midwifery, shoulder difficulty rate and neonatal asphyxia in the two groups ( P>0.05). The incidence of vaginal midwifery was 10.9% (14/129) and 2.2% (2/93) respectively in the upright group with pharmacological analgesia and non pharmacological analgesia, and the difference was statistically significant (Fisher's exact test, P<0.05). The duration of the second stage of labour was 53 (32, 85), 41 (27, 59) min in the supine group with pharmacological analgesia and non pharmacological analgesia, and the difference was statistically significant ( Z=-3.28, P<0.05). Conclusions:The adoption of upright position in the second stage of labour for primiparas can shorten the duration of the second stage, and reduce the rate of lateral episiotomy which can optimize the delivery outcome. For primiparas with pharmacological analgesia, it is recommended to use an upright position for delivery if conditions permit.
