Tannous Andrew M, Warffuel Jessica, Van Backle Ann-Sophie, Burgard Iris, Israel Marcella R, Hartley Sarah, Ramos Jania A, Stickrath Elaine, Metz Torri, Alston Meredith J
Department of Obstetrics and Gynecology, Saint Joseph's Hospital, Denver, the Women's Clinic of Northern Colorado, Fort Collins, and the Department of Obstetrics and Gynecology, UC Health, Steamboat Springs, Colorado; and the Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah.
O G Open. 2024 Aug 1;1(3):24. doi: 10.1097/og9.0000000000000024. eCollection 2024 Sep.
This is a review of evidence-based management of vaginal birth, which is critical to optimizing the outcomes of birthing people and neonates. The current literature supports the use of immediate pushing in the second stage of labor, neuraxial anesthesia administration for vaginal birth for adequate pain control, use of warm compresses in labor to prevent obstetric lacerations, delayed cord clamping for term and preterm neonates, the utility of umbilical cord milking in neonates who require immediate resuscitation, and active management of the third stage of labor with oxytocin administration. In addition, the routine use of episiotomy is shown to increase morbidity without clear evidence of benefit in the setting of spontaneous vaginal delivery or operative vaginal delivery.
这是一篇关于阴道分娩循证管理的综述，对于优化产妇和新生儿的分娩结局至关重要。当前文献支持在第二产程立即用力分娩、采用椎管内麻醉进行阴道分娩以实现充分的疼痛控制、在分娩时使用热敷预防产科裂伤、对足月儿和早产儿延迟脐带结扎、对需要立即复苏的新生儿进行脐带挤血以及使用缩宫素积极处理第三产程。此外，在自然阴道分娩或手术阴道分娩情况下，常规使用会阴切开术虽无明显益处却会增加发病率。
