分娩硬膜外镇痛与器械助产的发生率

Labor epidural analgesia and the incidence of instrumental assisted delivery.

作者信息

Rimaitis Kęstutis, Klimenko Olga, Rimaitis Marius, Morkūnaitė Asta, Macas Andrius

机构信息

Department of Anesthesiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.

出版信息

Medicina (Kaunas). 2015;51(2):76-80. doi: 10.1016/j.medici.2015.02.002. Epub 2015 Mar 25.

DOI:10.1016/j.medici.2015.02.002

PMID:25975875

Abstract

OBJECTIVE

To assess the influence of labor epidural analgesia on the course of labor and to determine its association with instrumental assisted delivery rate.

MATERIALS AND METHODS

A retrospective case-control study was performed during 2007-2011 aiming to identify the relation between epidural analgesia (EA) and instrumental assisted delivery (IAD) rate. All patients in whom instrumental assistance for delivery was applied were allocated into either case (parturients who received EA and had IAD) or control (parturients who did not receive EA but had IAD) groups. Maternal demographic data, pregnancy and delivery characteristics as well as neonatal short-term outcome were studied.

RESULTS

A total of 7675 vaginal deliveries occurred during the study period and 187 (2.43%) patients had IAD. Vacuum extraction was applied to 67 (2.16%) parturients who received EA, and to 120 (2.61%) who did not. The median duration of the first stage of labor was 510 min in the EA group as compared to 390 min in the control group (P=0.001). The median duration of the second stage of labor among cases and controls was 60 and 40 min, respectively (P<0.0005). Cases more often had their labor induced by oxytocin 80.3% as compared to 58.3% among controls (P=0.003). There was no significant association between the use of EA and increased IAD rate (OR=0.81; 95% CI, 0.60-1.09).

CONCLUSIONS

Labor EA did not increase the incidence of IAD and the risk of adverse neonatal outcomes, but was associated with prolonged first and second stages of labor.

摘要

目的

评估分娩硬膜外镇痛对产程的影响，并确定其与器械助产率的关联。

材料与方法

于2007年至2011年进行了一项回顾性病例对照研究，旨在确定硬膜外镇痛（EA）与器械助产（IAD）率之间的关系。所有接受器械助产的患者被分为病例组（接受EA且进行IAD的产妇）或对照组（未接受EA但进行IAD的产妇）。研究了产妇的人口统计学数据、妊娠和分娩特征以及新生儿短期结局。

结果

研究期间共发生7675例阴道分娩，187例（2.43%）患者进行了IAD。67例（2.16%）接受EA的产妇使用了真空吸引助产，未接受EA的产妇中有120例（2.61%）使用了真空吸引助产。EA组第一产程的中位持续时间为510分钟，而对照组为390分钟（P = 0.001）。病例组和对照组第二产程的中位持续时间分别为60分钟和40分钟（P < 0.0005）。病例组使用缩宫素引产的比例更高，为80.3%，而对照组为58.3%（P = 0.003）。EA的使用与IAD率增加之间无显著关联（OR = 0.81；95%CI，0.60 - 1.09）。