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初产妇第一产程进展缓慢时早期与延迟使用催产素治疗后女性的体验:一项随机对照试验。

Women's experiences after early versus postponed oxytocin treatment of slow progress in first childbirth--a randomized controlled trial.

机构信息

Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.

出版信息

Sex Reprod Healthc. 2012 Jun;3(2):61-5. doi: 10.1016/j.srhc.2012.03.003. Epub 2012 Mar 24.

Abstract

OBJECTIVE

The aim was to compare the childbirth experiences of primiparous women with slow labour progress who had received early versus postponed oxytocin augmentation.

METHODS

The population included healthy primiparous women with slow labour progress after a normal pregnancy and spontaneous onset of active labour at term who had taken part in a randomized controlled trial at two delivery units in Sweden comparing early versus postponed oxytocin augmentation. A total of 536 women were sent the Childbirth Experience Questionnaire (CEQ) one month postpartum. The 22-item questionnaire assesses four domains of the childbirth experience. Main outcomes were the four domains of the CEQ: Own capacity, Professional support, Perceived safety and Participation.

RESULTS

There were no significant differences between the women in the early and expectant oxytocin treatment groups in any of the four domains; however, operative births were associated with significantly worse childbirth experiences. Almost every third woman in both groups had negative and depressing memories from the childbirth process.

CONCLUSIONS

Early oxytocin augmentation for slow labour progress does not appear to be more beneficial than expectant management regarding women's perceptions of childbirth one month postpartum. Given the risks for the foetus associated with oxytocin treatment, prudent expectant management seems to be a safe and viable alternative.

摘要

目的

比较产程进展缓慢的初产妇接受早期与延迟催产素引产的分娩体验。

方法

本研究纳入了在瑞典两个分娩单位参加一项比较早期与延迟催产素引产的随机对照试验的健康初产妇,这些产妇具有正常妊娠、足月且自发性进入活跃期产程但产程进展缓慢。共有 536 名妇女在产后 1 个月时被发送了分娩体验问卷(CEQ)。该 22 项问卷评估了分娩体验的四个领域。主要结局是 CEQ 的四个领域:自身能力、专业支持、感知安全性和参与度。

结果

在早期和期待性催产素治疗组的四个领域中,没有任何一个领域存在显著差异;然而,剖宫产与分娩体验显著恶化相关。在两个组中,几乎每三个妇女都对分娩过程有负面和压抑的记忆。

结论

对于初产妇而言,在产程进展缓慢时,早期使用催产素引产似乎并不比期待性管理更有益于产妇对分娩的感知。鉴于催产素治疗与胎儿相关的风险,谨慎的期待性管理似乎是一种安全可行的替代方法。

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