Imarengiaye C O, Andet A B A
Department of Anaesthesiology, University of Benin Teaching Hospital, PMB 1111, Benin City, Nigeria.
West Afr J Med. 2008 Jul;27(3):148-51.
Pain free immediate postpartum period may encourage return to normal activities of daily living.
To identify the place of postpartum perineal pain as morbidity in the immediate postpartum period.
This prospective study included women who delivered in the Maternal Fetal Medicine Unit of the hospital. All women over 18 years who were delivered of a live neonate vaginally and were in hospital for at least 3 days after delivery were studied. The mothers were interviewed to describe the nature of perineal pain after delivery. The primary outcome was the frequency of perineal pain on days 1 and 3. The severity of perineal pain was assessed using interference with activities of daily living.
A total of 143 patients completed the form out of the 151 approached. There were 47 (32.9%) parturients with intact perineum, 28 (19.6%) sustained first or second-degree tears and 68 (47.5%) had episiotomy. The occurrences of perineal pain among the groups during hospitalization day one v day three were as follows: intact perineum 18(38.3%), 13(27.7%); 1st-/2nd-degree tears 20971%) and 14(50%); and episiotomies 59(86.8%) and 47(69.1%). Episiotomy was twice likely to produce perineal pain than no trauma group at time of discharge on day 3 (RR = 2.4).
The likelihood of being underserved in the management of perineal pain increased with minor perineal trauma and episiotomy respectively in the immediate postpartum period. The current management of postpartum perineal pain in our centre appears inadequate.
产后即时无痛期可能有助于恢复正常的日常生活活动。
确定产后即时会阴痛作为一种发病情况的地位。
这项前瞻性研究纳入了在医院母胎医学科分娩的女性。研究对象为所有年龄超过18岁、经阴道分娩活产新生儿且产后至少住院3天的女性。对母亲进行访谈以描述产后会阴痛的性质。主要结局是第1天和第3天会阴痛的发生率。使用对日常生活活动的干扰来评估会阴痛的严重程度。
在151名被邀请者中，共有143名患者完成了表格。47名（32.9%）产妇会阴完整，28名（19.6%）发生一度或二度撕裂伤，68名（47.5%）行会阴切开术。各组在住院第1天和第3天会阴痛的发生率如下：会阴完整组18例（38.3%）、13例（27.7%）；一度/二度撕裂伤组20例（71%）和14例（50%）；会阴切开术组59例（86.8%）和47例（69.1%）。在第3天出院时，会阴切开术导致会阴痛的可能性是无创伤组的两倍（相对危险度=2.4）。
在产后即时，会阴痛管理中未得到充分治疗的可能性分别随着轻微会阴创伤和会阴切开术而增加。我们中心目前对产后会阴痛的管理似乎并不充分。
