The impact of unprotected perineal assistance on the rate of lateral episiotomy during childbirth for primiparas
无保护会阴助娩法对初产妇分娩过程中会阴侧切率的影响

摘要

本研究的主要目的是探讨无保护会阴助娩法在初产妇分娩过程中对会阴侧切率的影响，旨在为优化分娩方式提供有力的临床依据。研究方法为：在2023年12月至2024年12月期间，选取在该院分娩的110例初产妇，对照组的产妇采用传统的保护会阴助娩法，而实验组则采用无保护会阴助娩法。通过观察和比较两组产妇的会阴侧切率、会阴裂伤程度、第二产程的时间、产后2小时内的出血量以及新生儿的Apgar评分，对两种助娩方式的效果进行了综合评估。研究结果显示，实验组的会阴侧切率为12.7%，显著低于对照组的38.2%（P<0.05），表明无保护会阴助娩法在降低会阴侧切率方面具有显著效果；实验组产妇的会阴Ⅰ度裂伤发生率高于对照组，但Ⅱ度及以上裂伤发生率却低于对照组（P<0.05），说明该方法在减少严重会阴裂伤方面同样有效；此外，实验组的第二产程时间也比对照组短（P<0.05），这可能与助娩方法的差异有关。然而，在产后2小时的出血量以及新生儿的Apgar评分方面，两组之间没有显著差异（P>0.05），表明无保护会阴助娩法并不会增加产后出血的风险，也不会对新生儿的健康造成不良影响。综上所述，无保护会阴助娩法能够有效降低初产妇的会阴侧切率，减少严重会阴裂伤的发生，缩短第二产程时间，且不会增加产后出血风险或影响新生儿的健康状况，因此，该方法值得在临床实践中推广应用。

Abstract

The main purpose of this study is to explore the effect of unprotected perineal assisted delivery on the perineal lateral resection rate during delivery in primiparous women, with the aim of providing strong clinical evidence for optimizing delivery methods. The research method is as follows: from December 2023 to December 2024, 110 primiparous women who gave birth in the hospital were selected. The control group of mothers used traditional perineal protection assisted delivery method, while the experimental group used unprotected perineal assistance delivery method. A comprehensive evaluation was conducted on the effectiveness of two assisted delivery methods by observing and comparing the perineal lateral incision rate, degree of perineal laceration, duration of the second stage of labor, amount of bleeding within 2 hours postpartum, and Apgar score of newborns between two groups of parturients. The research results showed that the perineal lateral incision rate of the experimental group was 12.7%, significantly lower than the control group's 38.2% (P<0.05), indicating that unprotected perineal assisted delivery method has a significant effect on reducing perineal lateral incision rate; The incidence of grade I perineal lacerations in the experimental group was higher than that in the control group, but the incidence of grade II and above lacerations was lower than that in the control group (P<0.05), indicating that this method is equally effective in reducing severe perineal lacerations; In addition, the second stage of labor time in the experimental group was shorter than that in the control group (P<0.05), which may be related to differences in delivery assistance methods. However, there was no significant difference (P>0.05) in the amount of bleeding 2 hours postpartum and the Apgar score of newborns between the two groups, indicating that unprotected perineal assisted delivery does not increase the risk of postpartum bleeding or have adverse effects on the health of newborns. In summary, unprotected perineal assisted delivery can effectively reduce the rate of perineal episiotomy in primiparous women, reduce the occurrence of severe perineal lacerations, shorten the second stage of labor, and do not increase the risk of postpartum hemorrhage or affect the health status of newborns. Therefore, this method is worth promoting and applying in clinical practice.