新产程标准下分娩镇痛对单胎足月初产妇分娩方式及母婴结局的影响

Effect of labor analgesia under the new standard of labor on the mode of delivery and maternal and infant outcomes of singleton term primipara

目的分析新产程标准下分娩镇痛对单胎足月初产妇分娩方式及母婴结局的影响。方法2020年10月至2022年4月产科收治的在新产程标准下应用分娩镇痛分娩的初产妇200例作为研究组,另外选择同期新产程标准下未使用分娩镇痛分娩的初产妇200例作为对照组,回顾性收集其临床资料。分析2组分娩方式、不同产程疼痛情况、母亲结局及新生儿出生情况。结果研究组自然阴道分娩比例更高,中转剖宫产比例更低(P<0.05)。研究组一产程、第二产程、第三产程视觉模拟评分(VAS)评分低于对照组(P<0.05)。研究组人工破膜、会阴裂伤、产后出血率低于对照组(P<0.05)。2组新生儿出生后1、5 min阿氏(Apgar)评分,脐动脉血动脉二氧化碳分压(PaCO_(2))、动脉氧分压(PaO_(2))、酸碱度(pH值)、新生儿窒息、出生体重、转新生儿重症监护病房情况比较,差异无统计学意义(P>0.05)。结论新产程标准下分娩镇痛可提高单胎足月初产妇自然阴道分娩率,降低中转剖宫产率,缓解产妇各产程疼痛,改善母亲结局,且加用麻醉药物并未影响新生儿出生情况。

Objective To analyze the effect of labor analgesia under the new standard of labor on the mode of delivery and maternal and infant outcomes of singleton term primipara.Methods From October 2020 to April 2022,200 singleton term primipara receiving labor analgesia under the new standard of labor were included in the research group,and 200 singleton term primipara under the new standard of labor without labor analgesia were included in the control groups.Their clinical data were retrospectively analyzed.Mode of delivery,pain in different outbound procedures,maternal and infant outcomes,and newborn births were compared.Results The proportion of natural vaginal delivery in the research group was significantly higher(72.00%vs 61.00%),and that of transferring to cesarean section was significantly lower(15.00%vs 23.00%,P<0.05).Visual simulation score(VAS)scores in the first,second and third stage of labor of the research group were significantly lower than those of control group(P<0.05).The artificial rupture of membranes(51.00%vs 62.00%),perineal laceration(36.00%vs 68.00%),and postpartum bleeding rate(4.00%vs 21.00%)of the research group were significantly lower than those of the control group(P<0.05).Apgar scores at 1 min and 5 min,partial pressure of carbon dioxide in umbilical artery blood(PaCO_(2)),arterial oxygen pressure(PaO_(2)),pH,the incidence of asphyxia neonatorum,birth weight,and transferring to neonatal intensive care unit were comparable between groups(P>0.05).Conclusion The singleton term primipara of labor analgesia under the new standard of labor could increase the natural vaginal delivery rate,reduce the rate of transferring to cesarean section,alleviate the pain in each stage of delivery and improve the maternal outcomes without influencing the newborn.