相关实验视频
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External Cephalic Version: Is it an Effective and Safe Procedure?
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在假定胎儿损害的情况下进行外周止痛和紧急分娩:对RAVEL多中心随机对照试验的后期分析
E S E Tabernée Heijtmeijer1, H Groen2, S E Damhuis1,3
1Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
概括
外周止痛疗法 (EDA) 与为胎儿痛苦而进行的紧急分娩有关,而不是患者控制的remifentanil止痛疗法 (PCRA). 低出生体重显著增加这种风险,无论在分娩期间疼痛管理.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 围产儿医学 围产儿医学
背景情况:
- 在分娩期间的疼痛管理对于母亲的经验至关重要.
- 外周止痛 (EDA) 和患者控制的remifentanil止痛 (PCRA) 是常见的方法.
- 了解它们对胎儿结果的影响是必不可少的.
研究的目的:
- 为了比较EDA和PCRA之间的假定胎儿损害的紧急分娩率.
- 调查出生体重五分位数对这一关联的影响.
主要方法:
- 对RAVEL随机对照试验的后期分析.
- 包括非异常单独怀孕 (36-42周怀孕).
- 随机选择EDA或PCRA,分析按出生体重五分位数分层.
主要成果:
- 与PCRA (8.3%) 相比,EDA与胎儿妥协 (14.8%) 的紧急分娩发生率更高.
- 用EDA与PCRA对胎儿妥协的调整几率比为1.69.
- 在胎儿妥协和出生体重较低的五分之一之间发现了显著的关联 (P=0.003).
结论:
- 与PCRA相比,产内EDA增加了与胎儿妥协的紧急分娩的可能性.
- 出生体重五分位数是胎儿妥协的紧急分娩的独立预测指标.
- 这些发现凸显了在分娩疼痛管理决策中考虑出生体重的重要性.
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