Rush J, Burlock S, Lambert K, Loosley-Millman M, Hutchison B, Enkin M
Birth. 1996 Sep;23(3):136-43. doi: 10.1111/j.1523-536x.1996.tb00474.x.
Showers and tubs in labor were not generally used in our center. When three whirlpool baths (Jacuzzis) were ordered as part of our renovations, a randomized, controlled trial was initiated to explore their effects on narcotic and epidural requirements.
This study employed an intent-to-treat design, and the sample size was estimated to account for the fact that some women would be unable to use the tub. The experimental group of 393 women was offered the tub during labor and the control group of 392 women received conventional care.
No births occurred in the tub. The tub group required fewer pharmacologic agents than controls (66% vs 59%, p = 0.06), experienced fewer deliveries by forceps and vacuum (p = 0.019), and were more likely to have an intact perineum than the standard-care group (p = 0.019). Labor was longer for the tub group (p = 0.003), who coincidentally were more primiparous and in earlier labor on admission. No differences were noted in the low rates of maternal and newborn signs of infection in women with ruptured membranes. A subset of mothers expressed satisfaction with the tub experience and labor support. The cesarean rate among both groups was lower (8.9%) than our overall rate (16.6%) during the study period.
Whirlpool baths in labor have positive effects on analgesia requirements, instrumentation rates, condition of the perineum, and personal satisfaction. Further study is being planned.
我们中心一般不使用分娩时的淋浴和浴缸。在我们进行翻新订购了三个漩涡浴缸（按摩浴缸）时，启动了一项随机对照试验，以探究其对麻醉剂和硬膜外麻醉需求的影响。
本研究采用意向性分析设计，样本量的估计考虑到了一些女性无法使用浴缸这一事实。393名女性的实验组在分娩时可使用浴缸，392名女性的对照组接受常规护理。
无人在浴缸中分娩。浴缸组所需的药物制剂比对照组少（66%对59%，p = 0.06），产钳和真空助产的情况较少（p = 0.019），且与会阴完整的标准护理组相比，浴缸组会阴完整的可能性更大（p = 0.019）。浴缸组的产程更长（p = 0.003），巧合的是，该组初产妇更多，入院时产程更早。胎膜破裂女性的母婴感染迹象发生率较低，两组之间无差异。一部分母亲对浴缸体验和分娩支持表示满意。研究期间两组的剖宫产率均低于我们的总体剖宫产率（16.6%）（8.9%）。
分娩时使用漩涡浴缸对镇痛需求、器械使用率、会阴状况和个人满意度有积极影响。正在计划进一步的研究。
