بررسی ارتباط نمره بیشاپ حین پذیرش با پیامدهای زایمانی در زنان نخست زا در بیمارستان 29 بهمن تبریز

نوع مقاله: اصیل پژوهشی

نویسندگان

1 مربی گروه مامایی، گروه مامایی، واحد تبریز، دانشگاه آزاد اسلامی، تبریز، ایران.

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

چکیده

مقدمه: هدف از مراقبت‌های زمان تولد، داشتن مادر و نوزاد سالم و دستیابی به یک زایمان طبیعی موفق است. از آنجایی که عدم آمادگی سرویکس منجر به افزایش سزارین و ایجاد عوارض مادری و نوزادی می شود، مطالعه حاضر با هدف بررسی ارتباط بین نمره بیشاپ حین پذیرش با پیامدهای زایمانی در زنان نخست‌زا انجام شد.
روش کار: این مطالعه توصیفی تحلیلی در سال 1394 بر روی 300 نفر از زنان باردار نخست‌زا مراجعه‌کننده به بخش زایمان بیمارستان 29 بهمن تبریز انجام شد. ابزار گردآوری داده‌ها شامل چک لیست مشخصات فردی، تاریخچه مامایی، اطلاعات نمره بیشاپ حین پذیرش واحدهای پژوهش و پیامدهای زایمانی بود. اطلاعات مورد نیاز از طریق مشاهده سیر زایمان و مطالعه مندرجات پرونده بیمار گردآوری شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS(نسخه 21) و آزمون همبستگی انجام شد. میزان p کمتر از 05/0 معنی ‌دار در نظر گرفته شد.
یافته‌ها: در این مطالعه بین نمره بیشاپ و طول مدت مرحله اول و دوم زایمان (0001/0=p)، طول انقباضات رحمی در مرحله اول زایمان (001/0=p)، الگوی ضربان غیر طبیعی قلب جنین در مرحله اول و دوم زایمان (0001/0=p)، استفاده از اکسی‌توسین (0001/0=p)، دفعات استفاده از اکسی‌توسین (0001/0=p)، فاصله بین آمنیوتومی یا پارگی خودبخودی پردهها تا زایمان(0001/0=p)، انجام اپی‌زیاتومی (01/0=p)، فشار بر فوندوس هنگام زایمان (001/0=p)، خونریزی بیش از حد بعد از زایمان (014/0=p)، آپگار دقیقه اول نوزاد (014/0=p) و اقدامات انجام شده بر روی نوزاد (009/0=p) ارتباط آماری معنی‌داری وجود داشت. روش زایمان (0001/0=p) با نمره بیشاپ حین بستری در بیمارستان ارتباط آماری معنی‌داری داشت؛ به طوری که 41 نفر (1/31%) از افراد با نمره بیشاپ کمتر یا مساوی 4 و 6 نفر (6/3%) از افراد با نمره بیشاپ بیشتر از 4 نیاز به انجام سزارین داشتند.
نتیجه‌گیری: نمره بیشاپ پایین و عدم آمادگی سرویکس منجر به افزایش پیامدهای نامطلوب زایمانی شده و با توجه به نتایج پژوهش باید اقداماتی جهت آماده کردن سرویکس به منظور ارتقاء امتیاز بیشاپ انجام داد.

کلیدواژه‌ها


عنوان مقاله [English]

The relationship between the Bishops score at admission and deliver outcomes in nulliparous women in 29 Bahman hospital, Tabriz

نویسندگان [English]

  • Somayyeh Naghizadeh 1
  • Azita Fathnezhad Kazemi 1
  • Shahla Hemmatzadeh 1
  • Mehdi Ebrahimpour 2
1 Instructor of Midwifery, Department of Midwifery, Tabriz Branch, Islamic Azad University, Tabriz, Iran.
2 M.Sc. in Librarianship, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
چکیده [English]

Introduction: The aim of care at birth is having a healthy mother and baby and achieving a successful vaginal delivery. Since unripe cervix leads to increased cesarean rate and causing maternal and neonatal complications, this study was performed with aim to investigate the relationship between Bishop Score at admission and delivery outcomes in nulliparous women.
Methods:This descriptive and analytic study was performed on 300 nulliparous women referring to 29 Bahman Hospital, Tabriz in 2015. Data collection tools included a checklist of individual characteristics, obstetric history, information about Bishop Score at admission, and delivery outcomes. Data were collected through observation of delivery course and studying the contents of the patient’s file. Data was analyzed by SPSS statistical software (version 21) and correlation test. PResults: There was significant relation between Bishop Score and duration of the first and second stage of labor (P=0.0001), duration of uterine contractions in the first stage of labor (P=0.001), abnormal fetal heart rate pattern in the first and second stage of labor (P=0.0001), using oxytocin (P=0.0001), frequency of using oxytocin  (P=0.0001), the distance between the amniotomi or rupture of membranes and delivery (P=0.0001), doing episiotomy (P=0.01), pressure on the  fundus during delivery (P=0.001),  excessive postpartum hemorrhage (P=0.014), first minute Apgar (p=0.014), and measures taken on newborn (P=0.009). Mode of delivery (P=0.0001) was significantly related to Bishop Score at admission, so that 41 cases (31.1%) with Bishop Score ≤4 and 6 (3.6%) with Bishop Score >4 needed to perform cesarean.
Conclusion: Low bishop score and unripe cervix lead to an increase in adverse delivery outcomes and according to the results of this study, proceedings must be done for cervical ripening to promote Bishop score.

کلیدواژه‌ها [English]

  • Bishop Score
  • Cesarean
  • Delivery outcome
  • Nulliparous
  • Vaginal delivery
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