Mallen-Perez Laura, Roé-Justiniano M Teresa, Colomé Ochoa Núria, Ferre Colomat Alicia, Palacio Montse, Terré-Rull Carme
Universidad de Barcelona, Hospital Clínic, Barcelona, España.
Sala de partos, Hospital Clínic, Barcelona, España.
Enferm Clin (Engl Ed). 2018 Sep-Oct;28(5):309-315. doi: 10.1016/j.enfcli.2017.10.004. Epub 2017 Nov 24.
To evaluate the effectiveness of the use of hydrotherapy in pain perception and requesting analgesia in women who use hydrotherapy during childbirth and to identify possible adverse effects in infants born in water.
A multicentre prospective cohort study was performed between September 2014 and April 2016. A total of 200 pregnant women were selected and assigned to the hydrotherapy group (HG) or the control group (CG) according to desire and availability of use, data collection started at 5cm dilatation. The instruments used were the numerical rating scale (NRS), use of analgesia, Apgar Test, umbilical cord pH and NICU admission. Participants were distributed into: HG (n=111; 50 water birth) and CG (n=89).
Pain at 30 and 90min was lower in the HG than in the CG (NRS 30min 6.7 [SD 1.6] vs 7.8 [SD 1.2] [P<.001] and NRS 90min 7.7 [SD 1.2] vs. 8.9 [SD 1.1] [P<.001]). During the second stage of labour, pain was lower in pregnant women undergoing a water birth (NRS HG 8.2 [SD 1.2], n=50; NRS CG 9.5 [SD 0.5], n=89 [P<.001]). Relative to the use of analgesia, in the CG 30 (33.7%) pregnant women requested epidural analgesia vs. 24 (21.1%) pregnant women in HG (P=.09). The neonatal parameters after water birth were not modified compared to those born out of water.
The use of hydrotherapy reduces pain during labour, and during second stage in women who undergo a water birth and the demand for analgesia decreases in multiparous pregnant women. No adverse effects were seen in infants born under water.
评估分娩期间使用水疗法对女性疼痛感知及镇痛需求的效果，并确定水中分娩婴儿可能出现的不良反应。
2014年9月至2016年4月进行了一项多中心前瞻性队列研究。根据意愿和使用情况，共选取200名孕妇，分为水疗法组（HG）或对照组（CG），宫口扩张5厘米时开始收集数据。使用的工具包括数字评分量表（NRS）、镇痛使用情况、阿氏评分、脐带血pH值和新生儿重症监护病房（NICU）收治情况。参与者分为：HG组（n = 111；50例水中分娩）和CG组（n = 89）。
HG组30分钟和90分钟时的疼痛程度低于CG组（NRS 30分钟：6.7[标准差1.6]对7.8[标准差1.2][P <.001]；NRS 90分钟：7.7[标准差1.2]对8.9[标准差1.1][P <.001]）。在第二产程中，水中分娩的孕妇疼痛程度较低（NRS HG组8.2[标准差1.2]，n = 50；NRS CG组9.5[标准差0.5]，n = 89[P <.001]）。关于镇痛使用情况，CG组有30名（33.7%）孕妇要求硬膜外镇痛，而HG组有24名（21.1%）孕妇要求（P = 0.09）。与非水中分娩的婴儿相比，水中分娩后新生儿参数未发生改变。
水疗法可减轻分娩期间的疼痛，在水中分娩的女性第二产程中疼痛减轻，经产妇对镇痛的需求减少。未观察到水中出生婴儿有不良反应。
