椎管内分娩镇痛对B族溶血性链球菌阳性孕妇阴道分娩结局的影响

The impact of intraspinal analgesia on vaginal delivery in pregnant women with Group B hemolytic streptococcus

目的:探究椎管内分娩镇痛对B族溶血性链球菌(group B streptococcal,GBS)阳性孕妇阴道分娩结局的影响。方法:采用回顾性研究方法分析2022年1月至2022年12月南京医科大学附属苏州医院收治的妊娠期GBS阳性孕妇212例,其中106例椎管内分娩镇痛孕妇为研究组,106例非椎管内分娩镇痛孕妇为对照组,比较两组孕妇及新生儿的围产结局。结果:两组孕妇的年龄、体质指数、孕次、产次和孕周均无统计学差异(P>0.05);研究组与对照组的产后出血量分别为[(284.34±67.13)ml vs(262.78±80.45)ml]、第一产程时间[(453.62±149.03)min vs(411.22±136.25)min]、第二产程时间[(46.11±19.33)min vs(40.59±17.22)min]和产时发热例数[21例(19.81%)vs 6例(5.66%)],两组比较差异均有统计学意义(P<0.05);两组孕妇的第三产程时间及会阴侧切、阴道助产、中转剖宫产和产后出血情况均无统计学差异(P>0.05);两组孕妇的新生儿体重、Apgar评分(1 min、5 min)、脐血pH、脐血剩余碱、新生儿窒息和入住新生儿重症监护室情况均无统计学差异(P>0.05)。结论:妊娠期GBS阳性孕妇实施椎管内分娩镇痛可以明显缓解疼痛,第一产程和第二产程时间可能会延长,但并不影响母儿分娩结局,是一种安全有效的分娩镇痛方式。

Objective:To investigate the impact of intravertebral analgesia on the outcome of vaginal delivery in pregnant women with Group B streptococcus(GBS).Methods:A total of 212 pregnant women with GBS were retrospectively selected from January 2022 to December 2022 in the Affiliated Suzhou Hospital of Nanjing Medical University,106 pregnant women with intraspinal analgesia were selected as the study group and 106 pregnant women without intraspinal analgesia were selected as the control group.The perinatal outcomes of pregnant women and newborns in the two groups were compared.Results:There were no significant differences in age,BMI,gravida,para and gestational weeks between the two groups(P>0.05).The postpartum blood loss[(284.34±67.13)ml vs(262.78±80.45)ml],the first stage of labor[(453.62±149.03)min vs(411.22±136.25)min],the second stage of labor[(46.11±19.33)min vs(40.59±17.22)min]and intrapartum fever[21(19.81%)vs 6(5.66%)]in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).There were no significant differences in the third stage of labor,lateral perineal incision,vaginal midwifery,cesarean section and postpartum hemorrhage between the two groups(P>0.05).There were no significant differences in neonatal weight,Apgar score(1 min,5 min),cord blood pH,BE,neonatal asphyxia and NICU admission between the two groups(P>0.05).Conclusions:Intravertebral analgesia in pregnant women with GBS in labor can significantly relieve pain,and the first and second stages of labor may be prolonged.However,it does not affect the perinatal outcome of mother and newborns,and is a safe and effective way of labor analgesia.