ارتباط طول مراحل زایمانی با نوع زایمان در زنان نخست زا در دو گروه زایمان فیزیولوژیک و مرسوم

نوع مقاله : اصیل پژوهشی

نویسندگان

1 مربی گروه مامایی، دانشکده پرستاری مامایی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

2 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تبریز٬ تبریز، ایران.

3 استادیار گروه فیزیولوژی، مرکز تحقیقات سلامت باروری زنان، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

چکیده

مقدمه: طولانی شدن مراحل زایمان، منجر به ایجاد پیامدهای نامطلوب زایمانی شامل افزایش زایمان سزارین، بستری نوزاد در بخش مراقبت های ویژه، عفونت بعد از زایمان و افزایش بار اقتصادی بر مردم و جامعه می شود. مطالعه حاضر با هدف بررسی ارتباط طول مدت مراحل زایمانی با نوع زایمان (فیزیواوژیک یا مرسوم) در زنان نخست زا انجام شد.
روش کار: این مطالعه کارآزمایی بالینی یک سوکور در سال 91-1390 بر روی 370 مادر نخست زا در بیمارستان شهید نورانی تالش انجام شد. افراد به صورت تصادفی در دو گروه 185 نفره جهت انجام زایمان فیزیولوژیک و مرسوم قرار گرفتند. اطلاعات مورد نیاز در این مطالعه از طریق مشاهده سیر زایمان، مصاحبه با مادران و مطالعه مندرجات پرونده آن ها گردآوری شد. ابزار جمع‌آوری اطلاعات، چک لیستی شامل مشخصات واحد های پژوهش، فرم پارتوگراف، ارزیابی مراحل اول، دوم و سوم بود. تجزیه و تحلیل داده ها با استفاده از نرم افزار آماری SPSS (نسخه 13) و آزمون های تی و کای اسکوئر انجام شد. میزان p کمتر از 05/0 معنی دار در نظر گرفته شد.
یافته ها: دو گروه از نظر میانگین طول مدت مرحله اول و دوم زایمان اختلاف معنی داری داشتند (001/0p<). طول مرحله اول و دوم زایمان در گروه زایمان فیزیولوژیک (48/123±23/421) طولانی تر از گروه زایمان مرسوم (28/131±45/243) بود (001/0p<). اما دو گروه از نظر میانگین طول مدت مرحله سوم تفاوت آماری معنی داری نداشتند (72/0=p). میزان زایمان طبیعی با اپی زیاتومی (9/44%) و سزارین (1/35%) در گروه زایمان مرسوم بیشتر از میزان زایمان طبیعی با اپی زیاتومی (9/18%) و سزارین (4/11%) در گروه زایمان فیزیولوژیک بود (001/0p<). زایمان طبیعی بدون اپی زیاتومی در گروه زایمان فیزیولوژیک (7/69%) بیشتر از گروه زایمان مرسوم (20%) بود که دو گروه از این نظر اختلاف آماری معنی داری داشتند (001/0p<).
نتیجه گیری: بر خلاف زایمان مرسوم، با افزایش طول مدت مراحل زایمانی در گروه زایمان فیزیولوژیک، میزان زایمان سزارین کاهش و زایمان طبیعی افزایش یافت.

کلیدواژه‌ها


عنوان مقاله [English]

Relationship between Length of Delivery Stages and Mode of Delivery for Nulliparous Women in Labor in Two Groups of Physiological and Traditional Delivery

نویسندگان [English]

  • Fahime Sehhati Shafaei 1
  • Samiyeh Kazemi 2
  • Morteza Ghojazadeh 3
1 Lecturer of Midwifery, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
2 M.Sc. of Midwifery, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
3 Assistant Professor, Department of Physiology, Women's Fertility Health Research Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
چکیده [English]

Introduction: If delivery stages become long, it leads to delivery harmful outcomes including increased rate of cesarean delivery, neonate's admission in NICU, postpartum infection, and increased economic impose on people and society. This study was performed to evaluate the relationship between length of delivery stages and mode of delivery in nulliparous women in two groups of physiological and traditional delivery.
Methods: This clinical blind study was performed on 370 nulliparous mothers at Talesh Shahid Noorani hospital during 2011-2012. People were randomly divided into two groups (185 member) of Physiological and Traditional Delivery. The required information was collected through observations of delivery stages, interviewing with mothers and studying the contents of their files. Data collection tool was a checklist including the characteristics of subjects, partograph form, assessment of first, second, and third stages of delivery. Data analysis was performed by SPSS software (version 13) and Chi-square, and t tests. PResults: Two groups were significantly different in terms of length of the first and the second stages of delivery (P<0.001). Length of the first and the second stages of delivery was longer in physiologic delivery group (421.23±123.48) than traditional delivery group (243.45±131.28) (P<0.001). But, length of the third stage did not show a statistically significant difference between two groups (P=0.72). In traditional delivery group, the rate of vaginal delivery with episiotomy (%44.9) and cesarean section (%35.1) was higher than vaginal delivery with episiotomy (%18.9) and cesarean section (%11.4) in physiologic delivery group (P<0.001). Vaginal delivery without episiotomy was higher in traditional delivery group (%69.7) than physiologic delivery group (%20) that two groups had statistically significant difference (P<0.001).
Conclusion: Unlike Traditional delivery, with increasing the length of delivery, the rate of cesarean delivery decreased and vaginal delivery increased.

کلیدواژه‌ها [English]

  • Length of delivery stages
  • Mode of Delivery
  • Nulliparous women
  • Physiological delivery
  • Traditional delivery
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