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早期硬膜外镇痛对产程的影响

The Impact of Early Epidural Analgesia on the Course of Labor and Delivery.

作者信息

Simanauskaite Atene, Kavaliauskaite Gabriele, Kacerauskiene Justina, Vilimiene Vilda

机构信息

Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.

出版信息

Medicina (Kaunas). 2025 Apr 18;61(4):750. doi: 10.3390/medicina61040750.

Abstract

: This study aimed to assess the impact of early epidural analgesia (EA) on the progression of labor and delivery outcomes among nulliparous women. : A retrospective analysis was conducted utilizing data from the Birth Registry of the Department of Obstetrics and Gynecology at LUHS. The dataset encompassed women who underwent childbirth between 1 January 2021 and 31 December 2021 and who received EA for labor pain management. A total of 89 women with low-risk deliveries and EA were included in the study. The cohort was divided into two groups: Group I-parturients who underwent early EA with cervical dilatation ≤3 cm-and Group II-parturients who underwent EA with cervical dilatation >3 cm but <7 cm. The results were processed using IBM SPSS. : Group I consisted of 25 (28.1%) women and Group II consisted of 64 (71.9%). The prevalence of obesity was higher in Group II ( = 0.021). Bishop score was statistically elevated in Group II ( = 0.018). Upon hospital admission, Group II exhibited greater cervical dilation ( = 0.001). The rate of cervical dilation was higher in Group II at 1.54 cm/h ( = 0.033). Episiotomy was more frequently performed in Group II ( = 0.014). The average durations of the first stage of labor ( = 0.045), the second stage of labor ( = 0.033), and the overall labor ( = 0.023) were prolonged in Group I. : The cervical dilation up to 10 cm occurs at a swifter pace when EA is administered following cervical dilation exceeding 3 cm. Notable associations were observed between EA and the incidence of episiotomy as well as the duration of labor stages. Early EA exhibited no impact on neonatal outcomes.

摘要

本研究旨在评估早期硬膜外镇痛(EA)对初产妇分娩进程及分娩结局的影响。:利用卢瑟福大学医院妇产科出生登记处的数据进行回顾性分析。该数据集涵盖了2021年1月1日至2021年12月31日期间分娩且接受EA进行分娩疼痛管理的女性。共有89例低风险分娩且接受EA的女性纳入研究。该队列分为两组:第一组——宫颈扩张≤3 cm时接受早期EA的产妇——和第二组——宫颈扩张>3 cm但<7 cm时接受EA的产妇。结果使用IBM SPSS进行处理。:第一组由25名(28.1%)女性组成,第二组由64名(71.9%)女性组成。第二组肥胖患病率更高(P = 0.021)。第二组Bishop评分在统计学上更高(P = 0.018)。入院时,第二组宫颈扩张更大(P = 0.001)。第二组宫颈扩张率更高,为1.54 cm/h(P = 0.033)。第二组更频繁地进行会阴切开术(P = 0.014)。第一组第一产程(P = 0.045)、第二产程(P = 0.033)及总产程(P = 0.023)的平均时长延长。:当宫颈扩张超过3 cm后给予EA时,宫颈扩张至10 cm的速度更快。观察到EA与会阴切开术发生率及产程时长之间存在显著关联。早期EA对新生儿结局无影响。

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Epidural analgesia in labor: A narrative review.分娩中的硬膜外镇痛:一项叙述性综述。
Int J Gynaecol Obstet. 2022 Nov;159(2):356-364. doi: 10.1002/ijgo.14175. Epub 2022 Mar 21.
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Labour analgesia: update and literature review.分娩镇痛:更新与文献回顾。
Hong Kong Med J. 2020 Oct;26(5):413-420. doi: 10.12809/hkmj208632. Epub 2020 Sep 17.

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