The effects of a series of posture intervention strategies guided by ultrasonography during labor process on the parturition with abnormal fetal head position
10.3760/cma.j.cn211501-20230109-00069
- VernacularTitle:产程中超声引导下系列性体位干预策略对异常胎方位分娩影响的研究
- Author:
Miaomiao FEI
1
;
Fang WANG
;
Luqing LU
;
Ying YAO
;
Yuanhui LIU
;
Qiong LUO
;
Suwen FENG
Author Information
1. 浙江大学医学院附属妇产科医院分娩室,杭州 310006
- Keywords:
Ultrasonography;
Posture;
Fetal head position;
Labor
- From:
Chinese Journal of Practical Nursing
2023;39(26):2020-2025
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical effects of a series of posture intervention strategies on correcting abnormal fetal position, so as to provide a basis for Clinical position management and promotion of natural delivery.Methods:This study was a randomized controlled trial. The convenience sampling method was used to select 196 full-term primiparas women with abnormal fetal orientation confirmed by ultrasound as single fetal head position in the Women′s Hospital, School of Medicine, Zhejiang University from March to October 2022 as the research objects. They were divided into control group 106 cases and research group 90 cases by random number table method. The control group received normal nursing and chose comfortable position by themselves during labor. The research group received a series of ultrasound-guided postural intervention strategies for postural management in the first and second stages of labor on the basis of normal nursing. The angle of progression and the midline angle, the fetal orientation, fetal orientation during complete uterine orifice and delivery outcome were compared between the two groups.Results:Finally, 190 cases were included, 105 cases in the control group and 85 cases in the research group. There were 76 vaginal deliveries in the research group and 95 in the control group. The rate of anterior occipital position and the angle of fetal head rotation in the research group were 73.68% (56/76) and 64.55 (37.90, 85.55)°, which were higher than 45.26% (43/95) and 33.00 (14.00, 60.00)° in the control group;the midline angle of the research group was 57.10(38.50, 75.80)°, which was lower than 80.00 (52.50, 90.30)° of the control group. There was significant difference between the two groups ( χ2 = 14.14, Z = 4.17, - 3.74, all P<0.01). The first stage of labor was 522.50 (413.00, 695.00) minutes and the total stage of labor was 611.00 (488.00, 812.00) minutes in the research group, which was lower than 620.00 (450.00, 795.00) and 700.00 (539.00, 904.00) minutes in the control group ( Z = - 2.34, - 2.03, both P<0.05). Conclusions:The application of the serial position intervention strategy under the ultrasound guidance during the labor process can improve the abnormal fetal position, shorten the first stage of labor time effectively and safely, while it does not have any significant effect on the improvement of the delivery outcome.