Chen Chen-Yu, Wang Kuo-Gon
Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
Taiwan J Obstet Gynecol. 2006 Dec;45(4):302-6. doi: 10.1016/S1028-4559(09)60247-3.
Routine interventions during labor and birth, such as perineal shaving and enemas before vaginal delivery, continuous intrapartum electronic fetal monitoring (EFM), and episiotomy are prevalent in Taiwan, but they may not always be necessary. Numerous studies investigating these interventions have failed to find absolute benefits for women with uncomplicated and low-risk pregnancies. No evidence-based benefits support routine perineal shaving or enemas during labor for reducing the risk of perineal wound infection or neonatal infection. The use of EFM is associated with an increased rate of operative interventions (vacuum, forceps, cesarean delivery) but does not result in a significant decrease in the incidence of perinatal death or cerebral palsy. Routine episiotomy does not have demonstrable advantages over restrictive episiotomy in the frequency or severity of perineal damage or pelvic relaxation.
分娩期间的常规干预措施，如阴道分娩前的会阴剃毛和灌肠、产时连续电子胎儿监护（EFM）以及会阴切开术，在台湾很普遍，但它们不一定总是必要的。众多针对这些干预措施的研究未能发现对无并发症的低风险孕妇有绝对益处。没有循证依据支持分娩期间常规会阴剃毛或灌肠可降低会阴伤口感染或新生儿感染风险。使用EFM与手术干预（真空吸引、产钳、剖宫产）率增加相关，但并未显著降低围产期死亡或脑瘫的发生率。在会阴损伤的频率或严重程度以及盆腔松弛方面，常规会阴切开术与限制性会阴切开术相比并无明显优势。
