Antonakou Angeliki, Papoutsis Dimitrios
Department of Midwifery, Midwifery School, "Alexander" Technological Educational Institute of Thessaloniki, Thessaloniki, Greece.
Department of Obstetrics and Gynaecology, Shrewsbury and Telford Hospitals NHS Trust, Shrewsbury, UK.
Obstet Gynecol Int. 2016;2016:5740534. doi: 10.1155/2016/5740534. Epub 2016 Nov 20.
. To investigate whether the use of epidural analgesia during induced labour was a risk factor for instrumental vaginal delivery and caesarean section (CS) delivery. . This was a retrospective case series of primigravidae women being induced at term for all indications with a normal body mass index (BMI) at booking and under the age of 40 years. . We identified 1,046 women who fulfilled the inclusion criteria of which 31.2% had an epidural analgesia. Those with an epidural analgesia had significantly greater maternal age, higher BMI, greater percentage of oxytocin usage, and a longer first and second stage of labour. Women with an epidural analgesia had a higher instrumental delivery (37.9% versus 16.4%; < 0.001) and CS delivery rate (26% versus 10.1%; < 0.001). Multivariable analysis indicated that the use of an epidural was not a risk factor for a CS delivery but was a risk factor for an instrument-assisted delivery (adjusted OR = 3.63; 95% CI: 2.51-5.24; < 0.001). . Our study supports the literature evidence that the use of an epidural increases the instrumental delivery rates. It has also added that there is no effect on CS delivery and the observed increase is due to the presence of confounding factors.
. 探讨引产期间使用硬膜外镇痛是否为器械助产阴道分娩及剖宫产的危险因素。. 这是一项回顾性病例系列研究，纳入足月因各种指征引产的初产妇，她们在孕早期体重指数（BMI）正常且年龄小于40岁。. 我们确定了1046名符合纳入标准的女性，其中31.2%使用了硬膜外镇痛。使用硬膜外镇痛的产妇年龄显著更大、BMI更高、催产素使用率更高，且第一产程和第二产程更长。使用硬膜外镇痛的女性器械助产率更高（37.9% 对16.4%；P<0.001），剖宫产率也更高（26% 对10.1%；P<0.001）。多变量分析表明，使用硬膜外镇痛不是剖宫产的危险因素，但却是器械助产的危险因素（校正比值比 = 3.63；95% 置信区间：2.51 - 5.24；P<0.001）。. 我们的研究支持文献证据，即使用硬膜外镇痛会增加器械助产率。研究还补充表明，硬膜外镇痛对剖宫产无影响，观察到的器械助产率增加是由于存在混杂因素。
