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Vpliv prisotnosti/odsotnosti oceta pri porodu na potek poroda in stanje novorojencka
Avtor: Robert Medved
Mentor: prof. dr. Marjan Pajntar
Izhodišca: Prisotnost ocetov pri rojstvu svojih otrok v ljubljanski porodnišnici iz leta v leto narašca, zato smo v raziskavi ovrednotili, kako prisotnost oceta pri porodu vpliva na potek poroda, stanje novorojencka in prvi stik z otrokom.
Metode: V raziskavo smo vkljucili 228 nakljucno izbranih porodnic, ki so rodile v ljubljanski porodnišnici v obdobju med 28. 10. 1997 in 1. 2. 1998, skupaj z njihovimi partnerji. Porodnice smo glede na prisotnost oceta pri porodu razvrstili v dve skupini: osnovno, eksperimentalno skupino (130 parov), v kateri so bili ocetje prisotni pri porodih svojih otrok, in kontrolno skupino (98 parov), kjer ocetje niso prisostvovali porodom. V raziskavi smo merili in spremljali objektivne podatke (poraba sredstev za lajšanje bolecin in krcev, oksitocina in prostaglandinov, trajanje poroda, ocena stanja novorojencka po Apgarjevi, plinska analiza popkovnicne krvi in porodniške operacije), anketirali porodnice in njihove partnerje (ankete so vsebovale splošna in psihološko obarvana vprašanja) ter anketirali babice (ankete so vsebovale vprašanja o njihovem pogledu na prisotnost oceta pri porodu).
Rezultati: V osnovni skupini je prejelo butilskopolamin venozno 38,2 % porodnic, kar je statisticno znacilno (p < 0,04) vecji odstotek, kot v kontrolni skupini, kjer ga je prejelo 24,4 % porodnic. Oksitocin je med porodom prejelo v osnovni skupini 71,5 % porodnic, v kontrolni skupini pa le 56,4 %. Razlika je statisticno znacilna (p < 0,028). Dolžine porodov v osnovni skupini so s povprecno vrednostjo 224,93 minut statisticno znacilno (p < 0,015) daljše kot v kontrolni skupini, kjer znaša povprecna vrednost 189,95 minut. Mediana ocen izkušnje poroda na lestvici od -5 do +5 je bila v osnovni skupini za porodnice in ocete 5, v kontrolni skupini pa manj, in sicer za porodnice 3 in za ocete 4. Razliki med skupinama sta za porodnice (p < 0,000) in ocete (p < 0,003) statisticno znacilni. Mediane ocen, v kolikšni meri je oziroma bi partnerjeva prisotnost olajšala porod porodnici, na lestvici od 0 do 10, so v osnovni skupini pri porodnicah 10, pri ocetih 9, v kontrolni skupini pa nižje, in sicer za porodnice in ocete 5. Razliki med skupinama sta tako za porodnice kot za ocete (p < 0,000) statisticno znacilni.
Zakljucki: Na osnovi analiz objektivnih podatkov in anket v naši raziskavi nismo mogli dokazati, da bi partnerjeva prisotnost pri porodu pozitivno vplivala na potek poroda, stanje novorojencka ali prvi stik z otrokom. Ugotovili pa smo, da prisotnost partnerja pri porodu vpliva pozitivno na porodnico predvsem psihološko
[Abstract / English version]
Vpliv prisotnosti/odsotnosti oceta pri porodu na potek poroda in stanje novorojencka
Author: Robert Medved
Mentor: prof. dr. Marjan Pajntar
Background: In the Ljubljana Maternity Hospital the percentage of fathers present at their baby's birth has been rising from year to year. The aim of this study was to evaluate the influence of father's presence on the course of labour, the newborn's condition and the first contact with the newborn.
Methods: In the study 228 randomly selected parturients who delivered in the Ljubljana Maternity Hospital in the period 28 October 1997 and 1 February 1998 and their partners were enrolled. They were divided into two groups. In the experimental group 130 parturients with their partners present at labour were allocated, and the control group consisted of 98 parturients whose partners were not present at labour. We analyzed the objective data: the doses of analgesics, oxytocin and prostaglandins used, duration of labour, neonatal Apgar scores, cord blood gas analysis, obstetrical operations, as well as the subjective data provided by two types of questionnaires. The first was filled-in by the parturients and their partners, the questions being general and psychological, and the second was filled-in by the midwives, the questions being related to the midwife's view on the presence of father at labour.
Results: Butylscopolamine was administered to a significantly higher percentage of women in the experimental than in the control group (38.2 % vs 24.4 %; p < 0.04). During labour oxytocin was administered to 71.5 % of women in the experimental group and to only 56.4 % of women in the control group, which is statistically significant (p < 0.028). The duration of labour was significantly longer in the experimental (mean 224.93 min) than in the control group (mean 189.95 min) (p < 0.015). The median value of the assessing the experience of labour on the scale from -5 to +5 was 5 for parturients and their partners in the experimental group, and 3 for parturients and 4 for their partners in the control group. The differences between the groups for mothers and for fathers are statistically significant (p < 0.000 and p < 0.003, respectively). The median value of the points given by the parents to evaluate the extent to which the partner facilitated labour to the parturient, the scale ranging from 0 to 10, was 10 for parturients and 9 for fathers in the experimental group, and 5 for both mothers and fathers in the control group. The differences between the groups are statistically significant for both mothers and fathers (p < 0.000).
Conclusions: The results of our analysis of both objective and subjective data do not prove that the father's presence at birth has a positive effect on the course of labour, the newborn's condition and the first contact. We have found, however, that the partner's presence has a positive psychological effect on the parturient.