Bloom S L, McIntire D D, Kelly M A, Beimer H L, Burpo R H, Garcia M A, Leveno K J
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas 75235-9032, USA.
N Engl J Med. 1998 Jul 9;339(2):76-9. doi: 10.1056/NEJM199807093390203.
Walking during labor may reduce patients' discomfort and improve outcomes. We conducted a randomized trial of walking during active labor to determine whether it altered the duration of labor or other maternal or fetal outcomes. Women with uncomplicated pregnancies between 36 and 41 weeks' gestation and in active labor were randomly assigned either to walking or to no walking (usual care). Pedometers were used to quantify walking, and the time spent walking was recorded.
Of the 536 women assigned to the walking group, 380 actually walked. Their mean (+/-SD) walking time was 56+/-46 minutes. There were no significant differences between the women assigned to the walking group and the 531 women assigned to the usual-care group in the duration of the first stage of labor (6.1 hours in both groups, P=0.83), the need for labor augmentation with oxytocin (23 percent vs. 26 percent, P=0.25), and the use of analgesia (84 percent vs. 86 percent, P=0.59). Similarly, the percentages of women requiring delivery by forceps (4 percent vs. 3 percent, P=0.35) and cesarean section (4 percent vs. 6 percent, P=0.25) were not significantly different. These labor and delivery outcomes were unrelated to walking in both nulliparous and parous women. The infants' outcomes were also similar in the two study groups.
Walking neither enhanced nor impaired active labor and was not harmful to the mothers or their infants.
分娩期间行走可减轻患者不适并改善分娩结局。我们对活跃期分娩时行走进行了一项随机试验,以确定其是否会改变产程或其他母体或胎儿结局。妊娠36至41周、处于活跃期且无并发症的孕妇被随机分为行走组或不行走组(常规护理)。使用计步器量化行走情况,并记录行走时间。
在分配到行走组的536名女性中,380名实际进行了行走。她们的平均(±标准差)行走时间为56±46分钟。在活跃期分娩的第一产程持续时间(两组均为6.1小时,P = 0.83)、使用缩宫素加强宫缩的需求(23%对26%,P = 0.25)以及使用镇痛剂的情况(84%对86%,P = 0.59)方面,分配到行走组的女性与分配到常规护理组的531名女性之间无显著差异。同样,需要产钳助产的女性百分比(4%对3%,P = 0.35)和剖宫产的女性百分比(4%对6%,P = 0.25)也无显著差异。这些分娩和接生结局在初产妇和经产妇中均与行走无关。两个研究组中婴儿的结局也相似。
行走既未增强也未损害活跃期分娩,且对母亲或其婴儿无害。