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目的 观察产妇精神状态 (焦虑及抑郁 )与分娩方式、分娩过程及产后出血的关系。 方法 92例健康无剖宫产指征的单胎初产妇 ,以焦虑自评量表 (SAS)及抑郁自评量表 (SDS)评定精神状态 ,按均分划分 SAS、SDS高分组及低分组。所有产妇以产科常规进行分娩而不进行干预 ,观察其分娩方式、产程及产后出血情况。 结果 (1) 92例产妇中顺产 80例 ,其中有 8例发生产后出血。(2 )中学文化程度组较大学文化程度组、顺产组较难产组、无产后出血组较产后出血组的 SAS、SDS评分均要低 ,各组间 SAS评分比较的 t值分别为 3.72、3.75、3.0 8,差异有非常显著性 (P<0 .0 1) ,SDS评分比较的 t值分别为 4.0 6 (P<0 .0 1)、2 .5 (P<0 .0 5 )、2 .6 2 (P<0 .0 5 ) ,差异亦有显著性。而SAS高分组产妇的第一、第二产程均较 SAS低分组要长 ,t值分别为 6 .5 3、5 .41,差异有非常显著性(P<0 .0 1)。同样 ,SDS高分组较 SDS低分组产妇的第一、第二产程也要延长 ,t值分别为 3.6 9、2 .6 8,差异亦有非常显著性 (P<0 .0 1)。 结论 焦虑及抑郁状态可增加难产及产后出血的发生率。故可提供有针对性的心理干预以提高产科质量。
Objective To observe the relationship between maternal mental status (anxiety and depression), mode of delivery, childbirth and postpartum hemorrhage. Methods A total of 92 healthy single mothers with no cesarean indications were enrolled in this study. SAS, SDS and SDS were used to assess the mental state. According to the mean score, SAS, SDS high-score group and low-score group . All mothers gave birth by obstetrical routine without intervention and observed the mode of delivery, labor process and postpartum hemorrhage. Results (1) Among the 92 maternal women, 80 had spontaneous delivery, of which 8 patients had postpartum hemorrhage. (2) SAS and SDS scores of secondary school education group were lower than that of university education group and non-labor group, and SAS group and SDS group were lower than those of postpartum group with postpartum hemorrhage. The t values of SAS score among the three groups were 3.72 and 3.75 , 3.08, the difference was significant (P <0.01). The t values of SDS score were 4.06 (P <0.01), 2.5 (P <0.05), 2 .6 2 (P <0.05), the difference was also significant. The SAS high-score group of maternal first and second stage of labor than the SAS low-score group to be longer, t values were 6 .5 3,5 .41, the difference was significant (P <0. Similarly, the first and second stage of labor in SDS high-score group were also longer than low-score SDS group, with t values of 3.6 9 and 2.68, respectively. The difference was also significant (P <0.01). Conclusion Anxiety and depression can increase the incidence of dystocia and postpartum hemorrhage. It can provide targeted psychological intervention to improve obstetric quality.