Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China.
J Obstet Gynaecol Res. 2022 Mar;48(3):729-738. doi: 10.1111/jog.15120. Epub 2021 Dec 27.
To evaluate whether early skin-to-skin contact at the end of the second stage of labor could relieve perineal wound suture pain.
From March 2020 to November 2020, a total of 241 parturients with full-term single fetuses delivered through the vagina and who underwent episiotomy suture (n = 120) or perineal laceration repair (n = 121) in our hospital were included in the study. Parturients were categorized according to whether they received episiotomy suture or perineal laceration repair. They were randomized into an early skin contact group and a traditional neonatal care group. The primary outcome was pain, which was quantified by the Numerical Rating Scale, Visual Analog Scale, Verbal Rating Scale, Faces Pain Scale-Revised. The secondary outcomes were healing of the perineal wound, the maternal cooperation rate and operation time. The confounding factors of severe pain were analyzed.
Early skin-to-skin contact alleviated the pain of perineal laceration repair and episiotomy suture, shortened the operation time of episiotomy suture and improved the cooperation rate of parturients receiving suture. It had no effect on perineal wound healing, operation time, or the cooperation rate of perineal laceration repair. In addition to the operation and early skin contact, the occurrence of high-grade pain was also associated with prepregnancy body mass index, group B streptococcus (GBS) positive, and academic degree.
Early skin-to-skin contact at the end of the second stage of labor can alleviate pain and improve the delivery experience of vaginal delivery.
评估第二产程末期进行早期皮肤接触是否可以缓解会阴伤口缝合疼痛。
本研究纳入 2020 年 3 月至 2020 年 11 月在我院分娩、行会阴侧切缝合术（n=120）或会阴裂伤修补术（n=121）的足月单胎产妇 241 例。根据是否行会阴侧切缝合术或会阴裂伤修补术将产妇分为侧切组和裂伤组。采用随机数字表法将产妇分为早期皮肤接触组和传统新生儿护理组。主要结局指标为疼痛，采用数字评分法、视觉模拟评分法、语言评分法、面部疼痛评分修订版进行量化。次要结局指标为会阴伤口愈合、产妇配合率和手术时间。分析重度疼痛的混杂因素。
早期皮肤接触减轻了会阴裂伤修补术和会阴侧切缝合术的疼痛，缩短了会阴侧切缝合术的手术时间，提高了缝合产妇的配合率。对会阴伤口愈合、手术时间、会阴裂伤修补术的配合率无影响。除手术和早期皮肤接触外，重度疼痛的发生还与孕前体质量指数、B 族链球菌（GBS）阳性和学历有关。
第二产程末期进行早期皮肤接触可以减轻疼痛，改善阴道分娩的分娩体验。
