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印度南部一家三级护理中心分娩硬膜外镇痛对分娩期望和体验的影响。

The impact of labour epidural analgesia on the childbirth expectation and experience at a tertiary care center in southern India.

作者信息

Bhatt Hitanshu, Pandya Sunil, Kolar Geeta, Nirmalan Praveen Kumar

机构信息

DNB Student, Department of Obstetrics, Fernandez Hospital , Hyderabad, India .

Head and Consultant, Department of Anesthesia and Critical Care Services, Fernandez Hospital , Hyderabad, India .

出版信息

J Clin Diagn Res. 2014 Mar;8(3):73-6. doi: 10.7860/JCDR/2014/8039.4111. Epub 2014 Mar 15.

Abstract

BACKGROUND

Labour epidural analgesia is increasingly used as a means of pain relief for women during labour and delivery. The significant pain during labour and delivery can be terrifying for mothers-to-be and the prospect of relief from pain can help reduce fear of childbirth to an extent. However, it is not necessary that reduced fear of childbirth may lead to an increased satisfaction with the childbirth experience.

AIM

To determine the influence of labour epidural analgesia (LEA) on the experience of childbirth in pregnant women at a tertiary care center in southern India Materials and Methods: A pre-post interventional non-randomized study design at a tertiary care perinatal institute that used the Wijma Delivery Expectation and Experience questionnaires to determine baseline expectations of labour and childbirth and the actual experience in pregnant women. Labour analgesia was provided on maternal request or demand. Total and domain scores were compared between the two groups using non-parametric tests and a generalized linear repeated measures model after adjusting for factors that were found significant in the bivariate model.

RESULTS

The study included 235 pregnant women who opted for LEA and 219 pregnant women who opted against LEA. Overall, 37 (15.74%) of woman with LEA and 30 (13.70%) of women without LEA had a worse than expected experience of childbirth. Significant pain relief (p<0.001) was provided with LEA, however, the post-delivery scores did not differ significantly between the two groups (F=0.90, p=0.34) in a generalized linear repeated measures model.

CONCLUSION

Maternal satisfaction with the process of childbirth is a complex dynamic that is not limited to the significant relief from pain provided by LEA.

摘要

背景

分娩硬膜外镇痛越来越多地被用作分娩期间缓解产妇疼痛的一种手段。分娩时的剧痛可能会让准妈妈们感到恐惧,而缓解疼痛在一定程度上有助于减轻对分娩的恐惧。然而,对分娩恐惧的减轻并不一定意味着对分娩体验的满意度会提高。

目的

确定分娩硬膜外镇痛(LEA)对印度南部一家三级护理中心孕妇分娩体验的影响。

材料与方法

在一家三级护理围产期研究所采用前后干预非随机研究设计,使用Wijma分娩期望与体验问卷来确定孕妇对分娩的基线期望和实际体验。根据产妇的要求提供分娩镇痛。在对双变量模型中发现有显著意义的因素进行调整后,使用非参数检验和广义线性重复测量模型比较两组的总分和各领域得分。

结果

该研究纳入了235名选择LEA的孕妇和219名未选择LEA的孕妇。总体而言,接受LEA的孕妇中有37名(15.74%)和未接受LEA的孕妇中有30名(13.70%)的分娩体验比预期差。LEA能显著缓解疼痛(p<0.001),然而,在广义线性重复测量模型中,两组产后得分无显著差异(F=0.90,p=0.34)。

结论

产妇对分娩过程的满意度是一个复杂的动态过程,并不局限于LEA所带来的显著疼痛缓解。

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