Cox Kim J, King Tekoa L
*College of Nursing, University of New Mexico, Albuquerque, New Mexico †Health Sciences Clinical Professor, School of Nursing, University of California, San Francisco, California.
Clin Obstet Gynecol. 2015 Jun;58(2):282-93. doi: 10.1097/GRF.0000000000000108.
The incidence of cesarean birth in the United States is alarmingly high and cesareans are associated with added morbidities for women and newborns. Thus strategies to prevent cesarean particularly for low-risk, nulliparous women at term with a singleton fetus are needed. This article addresses evidence-based practices that may be used during intrapartum to avoid primary cesarean, including patience with progress in labor, intermittent auscultation, continuous labor support, upright positions, and free mobility. Second-stage labor practices, such delayed pushing and manual rotation of the fetus, are also reviewed. This package of midwifery-style care practices can potentially lower primary cesarean rates.
美国剖宫产的发生率高得惊人，剖宫产会给产妇和新生儿带来更多发病风险。因此，需要采取策略来预防剖宫产，尤其是针对足月单胎妊娠的低风险初产妇。本文探讨了分娩期可用于避免首次剖宫产的循证实践，包括耐心等待产程进展、间歇听诊、持续分娩支持、直立位和自由活动。还对第二产程的实践，如延迟用力和徒手旋转胎儿进行了综述。这套助产式护理实践有可能降低首次剖宫产率。
