第一产程不同时期应用分娩镇痛对母婴结局的影响

吴宁宁; 田玲; 王倩; 王欲; 单婉君; 吴梦丽

doi:10.13898/j.cnki.issn.1000-2200.2023.02.014

第一产程不同时期应用分娩镇痛对母婴结局的影响

Effects of application of labor analgesia at different stages of the first stage of labour on maternal and infant outcomes

摘要

摘要:
目的探讨于第一产程不同时期使用硬膜外阻滞分娩镇痛对母婴结局的影响。
方法选取足月初产妇144例，未实施分娩镇痛者为对照组，实施分娩镇痛者为观察组，并按照实施分娩镇痛的时机分为观察组1（宫口扩张 < 3 cm）、观察组2（宫口扩张3~4 cm）和观察组3（宫口扩张>4 cm）。比较各组产程时间、中转剖宫产率、会阴侧切率、助产分娩率及新生儿Apgar评分。
结果观察组1组的第一产程时间均显著长于其他组（P < 0.01），各组第二产程、第三产程时间比较差异均无统计学意义（P > 0.05）。观察组自然分娩率高于对照组（P < 0.05）；观察组分娩中转剖宫产率低于对照组（P < 0.01）。各观察组间侧切分娩率、助产分娩率比较差异均无统计学意义（P > 0.05）；各观察组比较观察组3组自然分娩率显著高于观察组1组（P < 0.01），观察组3组中转剖宫产率显著低于观察组1组（P < 0.01）。观察组1、2、3组及对照组新生儿的1 min Apgar评分、5 min Apgar评分比较差异均无统计学意义（P > 0.05）。
结论应用分娩镇痛技术可显著降低分娩中转剖宫产率，减少剖宫产术对母儿造成的不良影响，可在临床工作中推广和应用，可优先选择宫口扩张3~4 cm时应用分娩镇痛。

Abstract:
ObjectiveTo explore the effects of the use of epidural block delivery analgesia at different stages of the first stage of labour on maternal and infant outcomes.
MethodsA total of 144 full-term primipara were selected.The patients who did not perform labor analgesia were selected as the control group, and the patients who performed labor analgesia were selected as the observation group.According to the timing of the implementation of labor analgesia, they were divided into observation group 1 (uterine orifice dilation < 3 cm), observation group 2 (3 cm ≤ uterine orifice dilation ≤ 4 cm) and observation group 3 (uterine orifice dilation >4 cm).The timing of labour, the rate of transit caesarean section, the rate of perineal cleavage, the rate of midwifery delivery, and the Apgar score of newborns were compared among the groups.
ResultsThe first stage of labor time in the observation group 1 was significantly longer than that in other groups(P < 0.01), and the difference in the time of second and third stages of labor was not statistically significant in each group (P > 0.05).The natural birth rate in the observation group was higher than that in the control group(P < 0.05).The rate of transit caesarean section in the observation group was lower than that in the control group(P < 0.01).There was no statistically significant difference in the comparison of the rate of lateral resection and the rate of midwifery delivery between the observation groups (P > 0.05).The natural birth rate of the observation groups 3 was significantly higher than that in the observation group 1 (P < 0.01), and the rate of transit caesarean section in the observation group 3 was significantly lower than that in the observation group 1 (P < 0.01).The 1-minute Apgar score and 5-minute Apgar score of neonates in the observation group 1, 2 and 3 and the control group were compared, and the results were not statistically significant (P > 0.05).
ConclusionsThe application of labour analgesia can significantly reduce the rate of caesarean section during delivery and reduce the adverse effects of caesarean section on mother and infant.It can be promoted and applied in clinical work.Therefore, labor analgesia can be preferentially selected when the uterine orifice is dilated to 3-4 cm.

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