Department of Obstetrics and Gynecology, Alavi Hospital, Ardabil University of Medical Science, Ardabil, Iran.
Infertility Fellowship, Ardabil University of Medical Science, Ardabil, Iran.
Int Tinnitus J. 2024 Mar 21;27(2):191-197. doi: 10.5935/0946-5448.20230029.
Labor pain is often severe and its lack of relief can have a bad effect on the mother's physiological condition. Accurate measurement and appropriate treatment of pain is an important problem. There are several choices for the control of labor pain, however, each method has its own risks and benefits regarding its efficiency and availability; therefore, the aim of this study was to compare the rate of cesarean section and newborn Apgar in two types of physiological delivery and facilitated delivery among mothers with first delivery.
This case-control study was conducted on mothers aged 18-35 who went to the hospital to give birth. In the present study, 8 sessions (90 minutes each session) were held to prepare mothers from 20 to 37 weeks of pregnancy. Candidate mothers for physiological labor were hospitalized without intervention and in the active phase of labor, and their labor stages were planned physiologically. The pain intensity of mothers was asked using a scale (VAS) during labor every half hour (according to the pain scale from 0 to 10). The average score of pain during the first and second stages, type of delivery, amount of postpartum bleeding, length of the stage of delivery, infection, and fever after delivery, Apgar score of the baby, perineal status, mother's satisfaction and the rate of hospitalization of the baby in NICU were recorded. Furthermore, the level of satisfaction with childbirth was evaluated with the help of Mackey's standard satisfaction questionnaire.
The average age of the physiological delivery and facilitated delivery groups was 26.37 ± 5.23 years and 26.58 ± 5.79 years, respectively. Physiological delivery significantly required less conversion to cesarean section. The most common etiology was caesarean section in the physiologic labor group, and a drop in NST was reported in the facilitated group. The analysis of the results demonstrated no significant difference between the etiology of cesarean section and the study groups. The Apgar score in the physiological group was significantly better than the facilitated group. There is no significant relationship between the study group and the amount of bleeding during delivery. Furthermore, there was no significant relationship between the study group and the incidence of postpartum infection. The rate of NICU admission in the facilitated group was found to be significantly higher than physiological delivery.
The results of this study revealed that the rate of caesarean section, the rate of need for NICU, newborns' Apgar score, and the rate of mothers' satisfaction in physiological delivery group were significantly different from the other groups, but the rate of wound infection and the amount of postpartum bleeding in the two groups showed a significant difference.
分娩疼痛通常很剧烈，而其无法缓解可能会对产妇的生理状况产生不良影响。准确测量和适当治疗疼痛是一个重要问题。控制分娩疼痛有几种选择，然而，每种方法在其效率和可用性方面都有其自身的风险和益处；因此，本研究的目的是比较初产妇中两种生理分娩和辅助分娩方式的剖宫产率和新生儿 Apgar 评分。
这是一项病例对照研究，研究对象为年龄在 18-35 岁之间、前往医院分娩的产妇。在本研究中，对妊娠 20-37 周的产妇进行了 8 次（每次 90 分钟）准备课程。生理性分娩的候选产妇在没有干预的情况下住院，并在分娩的活跃期，按照生理计划分娩阶段。在分娩过程中，每隔半小时使用（疼痛量表为 0-10）疼痛量表询问产妇的疼痛强度。记录产妇第一和第二产程的平均疼痛评分、分娩类型、产后出血量、分娩阶段的长度、感染和产后发热、婴儿的 Apgar 评分、会阴状况、母亲的满意度和婴儿在新生儿重症监护病房（NICU）的住院率。此外，借助 Mackey 标准满意度问卷评估了分娩满意度。
生理性分娩组和辅助分娩组的平均年龄分别为 26.37 ± 5.23 岁和 26.58 ± 5.79 岁。生理性分娩明显需要较少的剖宫产转换。在生理分娩组中最常见的病因是剖宫产，而在辅助分娩组中则报告了 NST 下降。结果分析表明，剖宫产的病因与研究组之间无显著差异。生理组的 Apgar 评分明显优于辅助组。研究组与分娩时出血量之间无显著关系。此外，研究组与产后感染发生率之间无显著关系。辅助组的 NICU 入院率明显高于生理性分娩组。
本研究结果表明，剖宫产率、需要 NICU 的比例、新生儿 Apgar 评分以及生理性分娩组产妇的满意度在统计学上均与其他组有显著差异，但两组产妇伤口感染率和产后出血量无显著差异。
