在早期自发分娩的多胎妇女中,按8小时或4小时安排的例行性阴道检查:一项随机对照试验
Izzati Radzali1, Narayanan Vallikkannu1, Mukhri Hamdan1
1Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, 50603, Kuala Lumpur, Malaysia.
American journal of obstetrics & gynecology MFM
|August 20, 2025
概括
预定第一个阴道检查时间为8小时,而不是4小时的分娩时间是不劣的. 然而,8小时间隔的母亲满意度显著降低,这表明早期劳动管理的权衡.
科学领域:
- 产科和妇科
- 生殖健康
- 临床试验研究
背景情况:
- 阴道检查对于监测分娩至关重要,
- 有限的数据存在于最佳时间和强度的产妇检查.
- 过早的干预,如催产素增强可能会产生反作用.
研究的目的:
- 为了比较预定第一个随访性阴道检查8小时和4小时后的早期自发分娩诊断在多胎妇女.
- 为了评估8小时间隔的非劣等性.
- 评估4小时间隔对母亲满意度的优势.
主要方法:
- 这是一项随机对照试验,涉及254名孕期多胎妇女.
- 参与者在产后8小时或4小时随机进行预定的第一次阴道检查.
- 主要结果:使用0-10数值评分尺度的出生时间 (非劣势) 和母亲满意度 (优势).
主要成果:
- 这8小时的间隔时间与出生时间不相差 (平均差异为- 0.5小时,p=0. 218).
- 在8小时组中,母亲的满意度显著降低 (中位数为8比9, p<0. 001).
- 8小时组显示氧化增强率降低 (22. 0% 与 34. 6% 相比,p=0. 026) 和外周止痛率降低 (7. 1% 与 15. 0%,p=0. 045).
结论:
- 第一次随访性阴道检查的8小时间隔不低于4小时间隔的分娩时间.
- 然而,将检查推迟到8小时显著降低了母亲的满意度.
- 临床决策应该平衡分娩进展监测与患者的舒适性和满意度.
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