da Silva Flora Maria Barbosa, de Oliveira Sonia Maria Junqueira Vasconcellos, Nobre Moacyr Roberto Cuce
Sapopemba Birth Center, Rua Borges Lagoa no. 512 apto. 93-A, Vila Clementino, São Paulo CEP 04038-000, Brazil.
Midwifery. 2009 Jun;25(3):286-94. doi: 10.1016/j.midw.2007.04.006. Epub 2007 Jul 25.
OBJECTIVE: to evaluate the effect of an immersion bath on pain magnitude during the first stage of labour. DESIGN: a randomised controlled trial comparing the pain scores of bathing and non-bathing nulliparous women during birth was employed. SETTING: the study was conducted at the Normal Birth Center of Amparo Maternal, São Paulo, Brazil. PARTICIPANTS: 108 birthing women, with 54 women randomly assigned to each group. INTERVENTIONS: when the birthing women presented at 6-7 cm of cervical dilation, they were placed in an immersion bath for 60 mins. OUTCOME MEASURES: pain scores, using a behavioural pain scale and a numeric scale, were recorded at two evaluation time points: at 6-7 cm of cervical dilation and 1h after the first pain score evaluation. FINDINGS: at the first evaluation, on the behavioural scale, the means were 2.1 for both groups (p=0.914; 95% confidence intervals (CI) 1.9-2.3 for the control group and 2.0-2.2 for the experimental group). On the numeric scale, the means were 8.7 and 8.5 for the control and experimental groups, respectively (p=0.235; 95% CI 8.2-9.2 for the control group and 8.1-8.9 for the experimental group). At the second evaluation, the pain score means for both scales were statistically higher in the control group than in the experimental group. On the behavioural scale, the scores were 2.4 vs. 1.9, respectively, for the control and experimental groups (p<0.001; 95% CI 2.2-2.6 for the control group and 1.7-2.1 for the experimental group). On the numeric scale, the scores were 9.3 vs. 8.5, respectively, for the control and experimental groups (p<0.05; 95% CI 8.9-9.7 for the control group and 8.1-8.9 for the experimental group). CONCLUSIONS: mean labour pain scores in the control group were significantly higher than those in the experimental group. The present findings suggest that use of an immersion bath is a suitable alternative form of pain relief for women during labour.
目的:评估浸浴对第一产程疼痛程度的影响。 设计:采用一项随机对照试验,比较分娩期间沐浴和不沐浴的初产妇的疼痛评分。 地点:该研究在巴西圣保罗安帕罗产妇正常分娩中心进行。 参与者:108名分娩女性,每组随机分配54名女性。 干预措施:当分娩女性宫颈扩张至6 - 7厘米时,将她们置于浸浴中60分钟。 观察指标:在两个评估时间点记录疼痛评分,使用行为疼痛量表和数字量表:宫颈扩张至6 - 7厘米时以及首次疼痛评分评估后1小时。 研究结果:在首次评估时,行为量表上,两组的均值均为2.1(p = 0.914;对照组95%置信区间[CI]为1.9 - 2.3,实验组为2.0 - 2.2)。数字量表上,对照组和实验组的均值分别为8.7和8.5(p = 0.235;对照组95% CI为8.2 - 9.2,实验组为8.1 - 8.9)。在第二次评估时,对照组两个量表的疼痛评分均值在统计学上均高于实验组。行为量表上,对照组和实验组的评分分别为2.4和1.9(p < 0.001;对照组95% CI为2.2 - 2.6,实验组为1.7 - 2.1)。数字量表上,对照组和实验组的评分分别为9.3和8.5(p < 0.05;对照组95% CI为8.9 - 9.7,实验组为8.1 - 8.9)。 结论:对照组的平均产痛评分显著高于实验组。目前的研究结果表明,浸浴是分娩期间女性缓解疼痛的一种合适替代方式。
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