自由体位分娩在剖宫产术后再次妊娠阴道分娩中的应用

doi:10.12280/gjfckx.20210844

摘要/Abstract

摘要：

孕妇产时不同的体位姿势会对母胎结局产生影响,自由体位分娩是产妇按照自我意愿自由选择姿势分娩,对产妇及新生儿均有诸多益处。目前随着我国二孩、三孩政策的放开,剖宫产术后再妊娠孕妇日益增多,由于选择阴道分娩的母胎结局明显优于再次剖宫产,越来越多的剖宫产术后再次妊娠孕妇选择阴道分娩,自由体位分娩在剖宫产术后再次妊娠阴道分娩（vaginal birth after cesarean,VBAC）产妇中的应用也积累了一定的经验。自由体位分娩不仅有助于缓解产妇紧张的情绪,产程中还可以通过变换体位预防及减少难产的发生,而VBAC产妇产程进展过快者,应避免采取直立位分娩以减少急产的发生;第二产程应避免选择蹲位或坐位,以预防重度会阴裂伤的发生。

关键词: 剖宫产后阴道分娩, 分娩, 体位, 会阴, 难产, 分娩,产道

Abstract:

Different posture of pregnancy women during delivery has an impact on maternal-fetal outcomes. Free posture delivery is a free choice of postpartum delivery according to the mother′s own will, which benefits for both mothers and newborns. At present, with the opening of the two-child and three-child policy in our country, there are more and more pregnant women after cesarean section. Since the maternal and fetal outcome of vaginal delivery is significantly better than that of elective repeat cesarean section, more and more pregnant women choose vaginal birth after cesarean (VBAC). The application of free posture delivery in VBAC parturients has also accumulated certain experience. Free posture delivery not only helps relieve maternal tension, but also prevents and reduces dystocia by changing postural positions during labor. For women with VBAC who progress too quickly in labor should avoid vertical delivery to reduce the occurrence of emergency labor. During the second stage of labor, squat or sitting position should be avoided to prevent the occurrence of severe perineal laceration.

Key words: Vaginal birth after cesarean, Parturition, Posture, Perineum, Dystocia, Labor,obstetric

刘广谱, 赵玲, 张晓丽, 张惠欣. 自由体位分娩在剖宫产术后再次妊娠阴道分娩中的应用[J]. 国际妇产科学杂志, 2022, 49(2): 133-136.

LIU Guang-pu, ZHAO Ling, ZHANG Xiao-li, ZHANG Hui-xin. Effect of Free Position on Delivery and Applications on Vaginal Birth after Cesarean[J]. Journal of International Obstetrics and Gynecology, 2022, 49(2): 133-136.

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