潜伏阶段的劳动的积极与标准支持 - 一个随机的,受控的临床试验
Marit Larsen1, Maria Underdal1, Øyvind Salvesen2
1Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway; Department of Obstetrics and Gynaecology, St. Olav's Hospital, Trondheim University Hospital, 7006 Trondheim, Norway.
概括
积极支持劳动 (PSL) 并没有减少无产妇的复杂分娩,但缩短了分娩时间. 这种方法可以帮助防止长期潜伏的分娩阶段,而不会影响安全.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 劳动和交付管理 劳动和交付管理
背景情况:
- 长期潜伏的分娩增加了产科干预和并发症的风险.
- 无卵子妇女特别容易受到长期分娩的影响.
- 有效的策略来管理劳动的潜伏阶段至关重要.
研究的目的:
- 为了评估主动劳动支持 (PSL) 是否减少复杂的分娩与标准劳动支持 (SSL) 相比,在潜伏阶段的绝育妇女.
- 评估PSL对分娩时间和其他母亲/新生儿结果的影响.
主要方法:
- 一个单一中心随机对照试验 (RCT) 涉及356名未婚妇女.
- 参与者处于分娩的潜伏阶段,有单胎,头,长期怀孕.
- 复杂的分娩被定义为一个复合的结局,包括仪器分娩,剖腹产,显著的血液损失,孕产妇发烧,肩膀缩,严重的周围裂或低的阿帕格分数.
主要成果:
- 在PSL (40%) 和SSL (34%) 组之间复杂分娩的复合率没有显著差异 (OR = 1.3,95%CI = 0.8-2.0).
- PSL组经历了更短的分娩时间,需要更低的最大氧化剂量.
- 阴道检查和新生儿重症监护室转移率相似;然而,PSL组中更多的女性接受了外周止痛.
结论:
- 潜伏期的积极支持劳动 (PSL) 并没有降低无产妇复杂分娩的发生率.
- PSL有效地缩短了分娩时间,并降低了最大的催产素剂量.
- PSL为管理长期潜伏分娩阶段提供了一个潜在的替代方案,确保母亲和新生儿的安全.
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