目的：探讨导乐分娩、无痛分娩和水中分娩等医疗服务对产妇分娩方式的影响。方法随机抽取单胎初产妇300例，收集其住院资料及分娩情况，并采用焦虑自评量表对其进行产前的心理状况评估，分析影响分娩方式的重要因素。结果导乐分娩、无痛分娩明显降低产妇剖宫产率。产妇年龄、导乐分娩、无痛分娩是影响产妇分娩方式的主要因素。结论提高产妇健康意识、改善产妇心理健康状况、减轻分娩疼痛等医疗服务可降低产妇剖宫产率，有效的社会、心理及医疗干预有利于保证母婴安全。

Objective To explore the role of medical services(Doula delivery,painless labor and water birth)in delivery modes. Methods A cross-sectional study for a total of 300 primipara with delivery,who were hospitalized in the Fourth Hospital of Shijiazhuang,Self-rating Anxiety Scale was administered to these pregnant women before parturition. Logistic regression analysis was used to analyze the related factors. Results Doula delivery,painless labor and water birth significantly reduced the rate of cesarean delivery. Logistic regression analysis showed that age,Doula delivery and painless labor were the main factors influencing delivery mode. Conclusion Better health education for enhancing health knowledge and health awareness of pregnant women,better mental status of pregnant women and releasing pain of delivery related to the pregnancy outcome,and they can bring benefit to the health of mothers and infants.

目的：探讨导乐陪伴对孕妇分娩方式影响。方法选择2011年1月至8月在我院分娩的240例产妇，分为两组，观察组120例实行导乐陪产服务。对照组120例采用常规服务模式。结果观察组满意度和自然分娩率明显高于对照组（P<0.05）。结论导乐陪伴可增强产妇阴道分娩信心，促进产妇身心健康，有效改善分娩结局，提高阴道分娩率，保证母婴安全，提高产科质量。

Objective To investigate Doula right way affect pregnant women. Methods January 2011 - August deliveries in our hospital 240 cases of maternal, divided into two groups, the observation group 120 cases of paternity implement doula services. Control group of 120 patients with conventional service model. Results The rate of satisfaction and significantly higher natural childbirth (P <0.05). Conclusion Doula can enhance confidence in maternal vaginal delivery, promote maternal health, improve birth outcomes, improve vaginal delivery rate, to ensure safe motherhood, to improve the quality of obstetrics.

目的：对疤痕子宫阴道分娩的可行性及注意事项进行分析研究。方法：选取70例疤痕子宫阴道分娩者设为观察组，选取同期70例非疤痕子宫阴道分娩者设为对照组，观察疤痕子宫阴道分娩者的阴道试产成功率及子宫破裂发生情况，比较两组产时出血量、产程、新生儿Apgar评分、住院时间。结果：观察组70例患者中62例（88.6%）阴道分娩成功，8例转剖宫产，无子宫破裂发生；两组产妇在新生儿窒息发生率、产时出血量、Apgar评分、平均产程、住院时间方面比较，差异无统计学意义（ P>0.05）。结论：疤痕子宫阴道分娩安全、可行，应严格掌握产妇禁忌证与适应证，严密观察产程，做好产前准备工作，确保母婴安全。

Objective To analyze the feasibility and matters need attention of uterine scar vaginal delivery. Method 70 cases of uterine scar vaginal delivery were selected as the observation group,70 cases of non-scarring of the uterus vaginal delivery at the same period were selected as the the control group,The success rate of vaginal trial production and the incidence of uterine rupture in the observation groupwere observed,The amount of bleeding,birth process,Apgar score and the hospitalization time in two groups were compared. Results There were 62 cases(88. 6%)successful vaginal delivery in 70 patients in the observation group,no uterine rupture;The difference of the inci-dence of neonatal asphyxia,amount of bleeding,birth process,Apgar score and the hospitalization time in two groups had no statistical sig-nificance(P>0. 05). Conclusion Uterine scar vaginal delivery is safety and feasible,to control maternal contraindications and indications strictly,observe the production proces

本研究通过分析产妇产后抑郁发生的相关因素，阐述与导乐陪伴分娩的关联性，探讨导乐陪伴分娩对预防产妇产后抑郁发生的影响和作用，旨在为产科医护工作者了解孕产妇产期心理应激特点、做好围生期心理保健、促进顺利分娩及保障母婴安全提供依据。

To analyze the related factors of postpartum depression happening, and to elaborate the relationship with doula. To investigate the effect of Doula in preventing postpartum depression can provide basis for obstetric medical professionals to understand the maternal perinatal psychological stress characteristics, well do perinatal mental health, promote the smooth delivery, and ensure their safety.

目的：研究硬膜外应用罗哌卡因复合芬太尼注射液在无痛分娩中的效果及安全性。方法：选择自愿接受无痛分娩初产妇120例为镇痛组，自然分娩的初产妇120例为对照组，观察两组产妇镇痛效果、产程时间、分娩方式以及对新生儿和产后出血的影响。结果：镇痛组较对照组镇痛效果明显，能缩短第一产程时间，降低剖宫产率，对新生儿及产后出血无明显影响。结论：罗哌卡因复合芬太尼用于硬膜外分娩镇痛是一种安全有效的无痛分娩方法，值得临床上推广应用。

Objectie:To study the clinical effect and safety of Ropivacaine combined Fentanyl injection in the epidural application of painless clildbirth. Methods :Choose to received primigravida patients 120 of painless childbith as study group, choose natural bith primigravida patients 120 as control group. Study group was adopted epidural puncture anesthesia, Compared two groups of primigravida of production time、aualgesia effect、delivery method and the influence of newborns、postpartum haemorrhage. Result Oberserved group of prinigravida can obviously shorten the first production time and reduse sesarean section rate. There was no significant on newborn Apgar and postpartum hemorrhage. Conclusion: Ropivacaine combined Fentanyl were used for painless childbirth,which is a safe、reliable way of painless,being worthy of the clinical application.