劳动疼痛缓解及其对孕产妇和产后结果的影响
Georgeana Debs Guesine1, Marina Carvalho Paschoini2, Giselle Agreli Melo1
1Universidade de Uberaba, Mário Palmério University Hospital, Gynecology and Obstetrics Service - Uberaba (MG), Brazil.
概括
劳动力镇痛时间影响结果. 早期 (≤4厘米) 或晚期 (≥9厘米) 的宫扩张增加了剖腹产,子分娩和围产期不良事件 (如胎儿胸) 的风险.
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:
- 产痛是分娩期间常见的干预措施.
- 给予分娩止痛的最佳时间仍然是正在进行的研究的主题.
- 了解宫扩张和止痛结果之间的关系对于患者的安全至关重要.
研究的目的:
- 评估分娩止痛药的时间与孕产妇和产周期的不良结果之间的关联.
- 为了确定与在宫扩张的不同阶段执行分娩止痛相关的特定风险.
主要方法:
- 回顾性队列研究,涉及接受分娩止痛的分娩者.
- 根据疼痛缓解时的宫扩张来分组患者:≤4厘米 (第一组),5-8厘米 (第二组) 和≥9厘米 (第三组).
- 在这三个组中,对母亲和围产期的不良结果进行了比较.
主要成果:
- 宫扩张≥9厘米的分娩止痛与子分娩的风险增加3.86倍,胎儿心肌梗塞和新生儿重症监护室入院率更高.
- 宫扩张≤4厘米的分娩止痛与剖腹产风险增加3.31倍和1分钟低Apgar分数的更高患病率有关.
- 第二组 (5-8厘米扩张) 没有像早期或晚期组那样显示出相同的高风险.
结论:
- 当子宫扩张≤4厘米或≥9厘米时,给予分娩止痛药与不良孕产妇和围产期结果的患病率增加有关.
- 这些发现表明,分娩止痛的时间可能会影响分娩干预和新生儿福祉.
- 可能需要进一步的研究来完善劳动止痛的最佳时间指南,以最大限度地降低风险.
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