Abhirami G R, Sathyavani C, George Carolin Elizabeth
Department of Obstetrics and Gynaecology, Bangalore Baptist Hospital, Bangalore, Karnataka India.
Community Health and Palliative Care Division, Bangalore Baptist Hospital, Bangalore, Karnataka India.
J Obstet Gynaecol India. 2022 Aug;72(Suppl 1):174-179. doi: 10.1007/s13224-022-01622-1. Epub 2022 Feb 23.
Elective labour induction is associated with more pain, intrapartum interventions, cesarean deliveries, as compared with spontaneous labour, necessitating the use of labour analgesia. Epidural analgesia is one popular method for control of pain. This study was to determine the effect of epidural analgesia on the maternal and fetal outcomes in women undergoing induction of labour, as adequate data in this specific population is relatively sparse.
This was a cross-sectional study conducted over a period of 18 months which included mothers with singleton term gestation with cephalic presentation admitted for induction of labour.
A sample of 238 mothers were included in the study. Among the study population, 52.7% opted for epidural analgesia. The pain score was less than 3/10 (VAS) in 81% of mothers who opted for epidural analgesia. The cesarean section rate was 20.5% and 34.3% in the epidural and non-epidural groups, respectively. After adjusting the confounding factors, there was a positive effect noted in the caesarean section rate among the epidural group, which was lesser than the non-epidural group. However, a higher instrumental delivery rate (18.8% vs. 10.5%, -value < 0.05) was noted in the epidural group. There was no significant difference in the duration of labour and fetal outcome in the two groups.
Epidural analgesia providing good pain relief in the majority of the mothers was reinforced. In our study, epidural analgesia was associated with a reduction of caesarean section rate after adjusting the confounding factor. Epidural analgesia did not affect the duration of labour, cesarean section rate and fetal outcome independently, however, it was associated with increased risk of instrumental delivery. The outcomes mainly depend on the confounding factors. Therefore, mothers can be provided with an evidence-based information regarding the effect of epidural analgesia in induced labour and help those seeking epidural analgesia to make an informed choice.
The online version contains supplementary material available at 10.1007/s13224-022-01622-1.
与自然分娩相比,择期引产会带来更多疼痛、产时干预及剖宫产,因此需要使用分娩镇痛。硬膜外镇痛是控制疼痛的一种常用方法。本研究旨在确定硬膜外镇痛对引产女性母婴结局的影响,因为该特定人群的充分数据相对较少。
这是一项为期18个月的横断面研究,纳入了因引产入院的单胎足月妊娠、头先露的母亲。
238名母亲纳入本研究。在研究人群中,52.7%选择了硬膜外镇痛。选择硬膜外镇痛的母亲中,81%的疼痛评分低于3/10(视觉模拟评分法)。硬膜外组和非硬膜外组的剖宫产率分别为20.5%和34.3%。在调整混杂因素后,硬膜外组剖宫产率有积极影响,低于非硬膜外组。然而,硬膜外组的器械助产率较高(18.8%对10.5%,P值<0.05)。两组的产程和胎儿结局无显著差异。
硬膜外镇痛能在大多数母亲中提供良好的疼痛缓解得到了证实。在我们的研究中,调整混杂因素后,硬膜外镇痛与剖宫产率降低相关。硬膜外镇痛本身并不影响产程、剖宫产率和胎儿结局,但与器械助产风险增加有关。结局主要取决于混杂因素。因此,可以为母亲提供关于硬膜外镇痛在引产中作用的循证信息,帮助寻求硬膜外镇痛的母亲做出明智选择。
在线版本包含可在10.1007/s13224-022-01622-1获取的补充材料。