在使用外周止痛治疗的分娩中延长第二阶段的分娩是产后尿的危险因素
Keisuke Miyamoto1,2, Hiroaki Komatsu1, Hiroki Nagata1
1Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Japan.
The journal of obstetrics and gynaecology research
|December 21, 2023
概括
外周止痛会增加产后尿的风险. 长时间的分娩第二阶段是接受外周止痛治疗的女性这种情况的独立风险因素.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 产后尿 (PUR) 是分娩后的一种潜在并发症.
- 外周止痛疗法通常用于劳动和分娩期间的疼痛管理.
研究的目的:
- 为了确定产后尿 (PUR) 的发生率,在分娩后使用外周止痛.
- 在接受了外周止痛药的妇女中识别与PUR相关的危险因素.
主要方法:
- 一个单一中心的回顾性研究,涉及208名女性 (107名没有外周止痛,101名有外周止痛).
- 倾向性得分匹配被用来调整诸如年龄,BMI,primiparity和劳动诱导等共变量.
- 进行了单变量和多变量分析,以确定PUR的风险因素.
主要成果:
- 在倾向性得分匹配 (p=0.02) 后,PUR的发生率在外周止痛组 (30%) 与没有外周止痛组 (11%) 相比显著更高.
- 在单变量分析中,初级生育和延长的第二阶段分娩被确定为PUR的显著风险因素.
- 延长的第二阶段分娩被证实是PUR的一个独立风险因素 (OR:3.18;95%CI:1.08-9.77).
- 所有PUR病例在分娩后的第四天就消失了.
结论:
- 在分娩后使用外周止痛治疗的整体产后尿率为25.7%.
- 长时间的第二阶段分娩是分娩后尿的独立风险因素,在接受外围止痛的妇女.
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