Abstract:

Objective　Free position as the way of active intervention in the second stage of puerpera with fever during painless labor, to shorten the second stage of labor and reduce fetal distress in uterus caused by fever during painless labor. Methods　A total of 80 cases of puerpera with fever during painless labor in Department of Obstetrics, Panyu Central Hospital from April 2020 to November 2021 were selected. They were numbered according to the sequence of maternal enrollment and were divided into a control group and an observation group with 40 cases in each group, with No. 1-40 as the control group and No. 41-80 as the observation group. The observation group was (28.450±4.095) years old with a body weight of (67.530±10.595) kg, and the control group was (27.800±3.969) years old with a body weight of (65.769±8.217) kg. The observation group exerted their strength at free position immediately at the beginning of the second stage of labor, and the control group exerted their strength at traditional lithotomy position with time delay. The second stage of labor, the rate of conversion from spontaneous labor to cesarean section, assisted delivery rate, and newborn birth status were compared between the two groups. Independent sample t test was used for the measurement data, and χ² test was used for the count data. Results　The second stage of labor of the observation group [(30.43±19.61) min] was lower than that of the control group [(73.10±32.33) min], with a statistically significant difference (P<0.05). The rate of conversion from spontaneous labor to cesarean section and assisted delivery in the observation group was significantly lower than that in the control group, with a statistically significant difference (P<0.05). The normal rate of neonates in the observation group was 75.0% (30/40), which was higher than that in the control group [47.5% (19/40)], with a statistically significant difference (P<0.05). Conclusion　Using free position during the second stage of labor as the way of active intervention for puerpera with fever during painless labor can shorten the second stage of labor, and reduce the rates of caesarean section, assisted delivery, and adverse neonatal condition.

Key words: Painless labor, Intrapartum fever, The second stage of labor, Active intervention, Free position

摘要： 目的　无痛分娩产时发热产妇第二产程利用自由体位积极干预，缩短第二产程，拟降低因无痛分娩产时发热引起的胎儿宫内窘迫。方法　选取2020年4月至2021年11月年广州市番禺区中心医院产科实施无痛分娩后出现产时发热产妇80例，按照产妇入组顺序进行编号，用数字先后顺序法分为对照组和观察组，每组40例，1～40号为对照组，41～80号为观察组。观察组年龄（28.450±4.095）岁，体质量（67.530±10.595）kg；对照组年龄（27.800±3.969）岁，体质量（65.769±8.217）kg。其中观察组采用第二产程开始立即用力配合自由体位用力的方法；对照组采用延迟用力加传统膀胱截石位用力的方法。比较两组第二产程的时间，顺产转剖宫产率、器械助产率，新生儿出生状况。计量资料采用独立样本t检验，计数资料采用χ²检验。结果　观察组第二产程时间（30.43±19.61）min低于对照组的（73.10±32.33）min，差异有统计学意义（P<0.05）；观察组顺产转剖宫产率及器械助产率明显低于对照组，差异有统计学意义（P<0.05）；观察组新生儿正常率为75.0%（30/40），高于对照组的47.5%（19/40），差异有统计学意义（P<0.05）。结论　对实施无痛分娩后出现产时发热的产妇第二产程应利用自由体位积极干预，以缩短第二产程，降低产妇剖宫率、器械助产率，减少新生儿不良状况。

关键词: 无痛分娩, 产时发热, 第二产程, 积极干预, 自由体位