Schiessl B, Janni W, Jundt K, Rammel G, Peschers U, Kainer F
Prenatal Medicine Unit, Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University, Maistr. 11, 80337 Munich, Germany.
Eur J Obstet Gynecol Reprod Biol. 2005 Jan 10;118(1):17-20. doi: 10.1016/j.ejogrb.2004.01.045.
To investigate the impact of parameters influencing the duration of the second stage of labor in vaginal deliveries.
1200 consecutive vaginal deliveries were analyzed. Descriptive statistics are reported for parity, duration of first and second stage of labor, maternal age, birth weight, position of the fetal head, epidural analgesia and oxytocin augmentation. Logistic regression analysis was performed to assess the contribution of different variables to the length of the second stage of labor.
The mean length of the second stage was 70 min. In univariate analysis, parity, oxytocin augmentation and epidural analgesia, as well as occipito-posterior presentation were significant parameters associated with a prolonged second stage of labor. No correlation was found for birth weight and maternal age. In multivariate regression analysis, nulliparity and epidural analgesia were the strongest risk factors for a prolonged second stage.
The impact of epidural analgesia on the second stage of labor should be considered in obstetrical management.
探讨影响阴道分娩第二产程时长的参数。
对1200例连续阴道分娩病例进行分析。报告了产次、第一和第二产程时长、产妇年龄、出生体重、胎头位置、硬膜外镇痛及缩宫素加强宫缩的描述性统计数据。进行逻辑回归分析以评估不同变量对第二产程时长的影响。
第二产程的平均时长为70分钟。单因素分析中，产次、缩宫素加强宫缩、硬膜外镇痛以及枕后位是与第二产程延长相关的显著参数。未发现出生体重和产妇年龄与之存在相关性。多因素回归分析中，初产妇和硬膜外镇痛是第二产程延长的最强危险因素。
产科管理中应考虑硬膜外镇痛对第二产程的影响。
