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剖宫产患病率及孕妇新生儿阿氏评分与第二产程平均时间分析

Prevalence of Cesarean Section and Analysis of Neonatal Apgar Score and the Mean Time of Second Phase of Labor in Pregnant Women.

作者信息

Shokrpour Maryam, Reza Parisa Pour Seyed, Sharifi Mehrzad, Kamali Alireza

机构信息

Department of Gynecology, Arak University of Medical Sciences, Arak, Iran.

Department of Surgery, Arak University of Medical Sciences, Arak, Iran.

出版信息

Med Arch. 2019 Dec;73(6):399-403. doi: 10.5455/medarh.2019.73.399-403.

DOI:10.5455/medarh.2019.73.399-403
PMID:32082008
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7007604/
Abstract

INTRODUCTION

The labor pain is probably the most severe pain a mother experiences in her lifetime and is usually severe and prolonged in women with pregnancy.

AIM

To evaluate the effects of labor epidural and spinal analgesia on the incidence of cesarean section in painless delivery.

METHODS

This randomized clinical trial was conducted on pregnant women aged 37-42 weeks of pregnancy. Female candidates for painless labor were divided into two groups: Epidural Analgesia (EA) and Spinal Analgesia (SA). Patients in the labor epidural group underwent analgesia using marcaine and fentanyl and after fully assuring the normal hemodynamic status of the mother and fetal hearth rate (FHR), labor spinal analgesia was used for other group.

RESULTS

The average age of mothers was 27.5 years, their mean gestational age was 39 weeks and their mean weight was determined to be 72 kg. Frequency of cesarean delivery in mothers was found as 12.9%. Significantly, the incidence of cesarean section in the labor epidural analgesia group was higher than the labor spinal analgesia group (P = 0.02). In addition, the mean second phase of delivery in the labor epidural analgesia group was significantly higher than the labor spinal analgesia group (P = 0.03). There was no significant in 1st and 5th min Apgar scores between groups in infants (8.6 and 9.6, respectively).

CONCLUSION

Labor epidural analgesia and labor spinal analgesia result in a significant reduction in pain due to normal delivery. Due to the similarity of Apgar and arterial blood gas (ABG) in neonates, labor epidural analgesia may serve as an alternative in childbirth delivery.

摘要

引言

分娩疼痛可能是母亲一生中经历的最剧烈的疼痛,在孕妇中通常较为严重且持续时间长。

目的

评估分娩硬膜外镇痛和脊髓镇痛对无痛分娩中剖宫产发生率的影响。

方法

本随机临床试验针对妊娠37 - 42周的孕妇进行。无痛分娩的女性候选者分为两组:硬膜外镇痛(EA)组和脊髓镇痛(SA)组。分娩硬膜外组患者使用布比卡因和芬太尼进行镇痛,在充分确保母亲正常血流动力学状态和胎儿心率(FHR)后,另一组使用分娩脊髓镇痛。

结果

母亲的平均年龄为27.5岁,平均孕周为39周,平均体重确定为72千克。母亲剖宫产的发生率为12.9%。值得注意的是,分娩硬膜外镇痛组的剖宫产发生率高于分娩脊髓镇痛组(P = 0.02)。此外,分娩硬膜外镇痛组的平均第二产程明显高于分娩脊髓镇痛组(P = 0.03)。两组婴儿出生后1分钟和5分钟的阿氏评分无显著差异(分别为8.6和9.6)。

结论

分娩硬膜外镇痛和分娩脊髓镇痛可显著减轻正常分娩引起的疼痛。由于新生儿阿氏评分和动脉血气(ABG)相似,分娩硬膜外镇痛可作为分娩时的一种替代方法。

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本文引用的文献

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Trial of labor after cesarean delivery in twin gestations: systematic review and meta-analysis.剖宫产术后再次妊娠经阴道分娩双胎的随机对照试验:系统评价和 Meta 分析。
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Knowledge and Acceptance of Labour Analgesia in Pregnant Women.孕妇对分娩镇痛的认知与接受情况
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The effect of epidural education on Primigravid Women's decision to request epidural analgesia: a cross-sectional study.硬膜外麻醉教育对初产妇要求硬膜外镇痛的决策的影响:一项横断面研究。
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Effect of epidural analgesia on mode of delivery.硬膜外镇痛对分娩方式的影响。
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Incidence of cesarean section and analysis of risk factors for failed conversion of labor epidural to surgical anesthesia: A prospective, observational study in a tertiary care center.剖宫产发生率及分娩硬膜外麻醉转为手术麻醉失败的危险因素分析:一项在三级医疗中心进行的前瞻性观察研究。
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CESARIAN SECTION - HIGHER RATE AND HIGHER CHALLENGES.
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Vaginal Delivery vs. Cesarean Section: A Focused Ethnographic Study of Women's Perceptions in The North of Iran.阴道分娩与剖宫产:伊朗北部女性认知的聚焦人种志研究
Int J Community Based Nurs Midwifery. 2015 Jan;3(1):39-50.
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The impact of intrapartum analgesia on labour and delivery outcomes in nulliparous women.分娩期镇痛对初产妇分娩及分娩结局的影响。
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