Department of Obstetrics and Gynecology, Ningde Municipal Hospital of Ningde Normal University, Ningde, Fujian, China.
J Obstet Gynaecol Res. 2023 Jun;49(6):1545-1550. doi: 10.1111/jog.15640. Epub 2023 Mar 27.
This study aimed to investigate the effects of epidural analgesia administered as early as cervical dilatation of 1 cm on labor interventions and maternal and neonatal outcomes.
This retrospective research recruited 1007 full-term primigravidas, who were distributed to two separate cohorts for eligibility: epidural analgesia 1 (cervical dilatation = 1 cm) and epidural analgesia 2 (cervical dilatation >1 cm). Labor interventions (artificial rupture of membranes and oxytocin administration) and duration of labor were the primary outcomes.
The effect of initiation timing of epidural analgesia on artificial membrane rupture was not statistically significant (adjusted odds ratio [OR]: 0.85 [0.58-1.24], p > 0.05). Less oxytocin was used in the epidural analgesia 2 group compared with the epidural analgesia 1 group (the adjusted OR: 0.68 [0.49-0.95], p < 0.05). There were no significant differences in the median time to latent phase of labor, active phase of labor, second, and third stages of labor (p > 0.05). There were no significant differences in maternal and neonatal outcomes between the epidural analgesia 1 group and the epidural analgesia 2 group.
Epidural analgesia could be administered at cervical dilatation = 1 cm.
本研究旨在探讨在宫颈扩张 1cm 时即开始硬膜外镇痛对分娩干预措施及母婴结局的影响。
这项回顾性研究纳入了 1007 例足月初产妇，将其分为两个独立队列以符合入选标准：硬膜外镇痛 1 组（宫颈扩张=1cm）和硬膜外镇痛 2 组（宫颈扩张>1cm）。分娩干预措施（人工破膜和催产素使用）和产程持续时间是主要结局。
硬膜外镇痛开始时间对人工膜破裂的影响无统计学意义（调整后的优势比[OR]：0.85[0.58-1.24]，p>0.05）。与硬膜外镇痛 1 组相比，硬膜外镇痛 2 组催产素使用量较少（调整后的 OR：0.68[0.49-0.95]，p<0.05）。潜伏期、活跃期、第二产程和第三产程的中位数时间无显著差异（p>0.05）。硬膜外镇痛 1 组和硬膜外镇痛 2 组的母婴结局无显著差异。
宫颈扩张 1cm 时即可进行硬膜外镇痛。
