Gillesby Erica, Burns Suzan, Dempsey Amy, Kirby Shirley, Mogensen Kami, Naylor Kelly, Petrella Joann, Vanicelli Rebecca, Whelan Breon
Labor & Delivery, Exempla Lutheran Medical Center, Wheat Ridge, CO 80033, USA.
J Obstet Gynecol Neonatal Nurs. 2010 Nov-Dec;39(6):635-44. doi: 10.1111/j.1552-6909.2010.01195.x.
To determine if the use of delayed pushing after the onset of the second stage of labor decreases the time of active pushing and decreases maternal fatigue.
Randomized clinical trial.
Labor and delivery unit of a not-for-profit community hospital.
PATIENTS/PARTICIPANTS: Convenience sample of nulliparous laboring women with epidural anesthesia.
Immediate or delayed pushing (2 hours) during the second stage of labor at the time of complete cervical dilatation.
The length of pushing, total length of the second stage, and maternal fatigue.
A total of 77 women were studied (immediate pushing group=39; delayed pushing=38). The immediate pushing group averaged 94 (± 57) minutes in active pushing, while the delayed pushing group averaged 68 (± 46) minutes, a statistically significant difference (p=.04). No significant differences were found in fatigue scores between the immediate and delayed pushing groups (p>.05).
We found that by delaying the onset of active pushing for 2 hours after the beginning of the second stage of labor, the time that nulliparous women with epidural anesthesia spent in active pushing was significantly decreased by 27%. Although the delayed pushing group rested for up to 2 hours, the total time in the second stage of labor averaged only 59 minutes longer than the immediate pushing group.
确定第二产程开始后采用延迟用力是否能缩短有效用力时间并减轻产妇疲劳。
随机临床试验。
一家非营利性社区医院的分娩科室。
患者/参与者：采用硬膜外麻醉的初产妇便利样本。
在宫颈完全扩张时的第二产程中立即用力或延迟2小时用力。
用力时间、第二产程总时长和产妇疲劳程度。
共研究了77名女性（立即用力组 = 39名；延迟用力组 = 38名）。立即用力组有效用力平均时长为94（±57）分钟，而延迟用力组平均为68（±46）分钟，差异有统计学意义（p = 0.04）。立即用力组和延迟用力组的疲劳评分无显著差异（p>0.05）。
我们发现，在第二产程开始后将有效用力延迟2小时，采用硬膜外麻醉的初产妇有效用力时间显著减少了27%。尽管延迟用力组休息了长达2小时，但第二产程的总时长仅比立即用力组平均长59分钟。
