Kim Jong-Woon, Kim Yoon Ha, Cho Hye Yon, Shin Hee-Young, Shin Jong Chul, Choi Sea Kyung, Lee Keun-Young, Song Ji-Eun, Lee Pil-Ryang
Department of Obstetrics and Gynecology, Chonnam National University Medical School , Gwangju , Korea .
J Matern Fetal Neonatal Med. 2013 Nov;26(16):1623-7. doi: 10.3109/14767058.2013.789851. Epub 2013 May 9.
The aim of this study was to evaluate the effect of inflatable obstetric belts on uterine fundal pressure in the management of the second stage of labor.
Between July 2009 and December 2010, 188 nulliparous women with a singleton pregnancy at term were enrolled and only one dropped. The participants were randomized to receive either standard care (control group, n = 91) or uterine fundal pressure by the Labor Assister (Baidy M-520/Curexo, Inc., Seoul, Korea; active group, n = 97) during the second stage of labor in addition to standard care. The Labor Assister is an inflatable obstetric belt that is synchronized to apply constant fundal pressure during a uterine contraction. The primary endpoint was duration of the second stage of labor in women who delivered vaginally (control, n = 80 versus active, n = 93). It was not analyzed in women who delivered by cesarean section (n = 14) and delivered precipitously (n = 1). The secondary outcomes are perinatal outcomes and perineal laceration. Participants received patient-controlled epidural analgesia.
The 93 women in the active group spent less time in the second stage of labor when compared to the 80 women in the control group (46.51 ± 28.01 min versus 75.02 ± 37.48 min, p < 0.001). There was no significant difference in perinatal outcomes and perineal laceration between the two groups.
The uterine fundal pressure exerted by the inflatable obstetric belt reduces the duration of the second stage of labor without complications in nulliparous women who receive patient-controlled epidural analgesia.
本研究旨在评估充气式产科束带在第二产程管理中对子宫底压力的影响。
2009年7月至2010年12月，纳入188名单胎足月妊娠的初产妇，仅1例退出研究。参与者被随机分为两组，一组接受标准护理（对照组，n = 91），另一组在标准护理基础上于第二产程接受Labor Assister（韩国首尔Baidy M - 520/Curexo公司生产；干预组，n = 97）施加的子宫底压力。Labor Assister是一种充气式产科束带，可在子宫收缩时同步施加恒定的子宫底压力。主要终点是经阴道分娩的女性第二产程的持续时间（对照组，n = 80；干预组，n = 93）。剖宫产分娩（n = 14）和急产（n = 1）的女性未纳入分析。次要结局是围产期结局和会阴裂伤。参与者接受患者自控硬膜外镇痛。
与对照组的80名女性相比，干预组的93名女性第二产程时间更短（46.51±28.01分钟 vs 75.02±37.48分钟，p<0.001）。两组围产期结局和会阴裂伤无显著差异。
对于接受患者自控硬膜外镇痛的初产妇，充气式产科束带施加的子宫底压力可缩短第二产程持续时间且无并发症。
