Labor Pain Treated with Acupuncture or Acupressure

Opioid-dependent women have an 80% to 90% unintended pregnancy rate, almost double the overall unintended pregnancy rate: 40% globally and 51% in north America. The prescription drug abuse milieu increases the possibility opioid abusing laboring patients. In 2012, neonatal abstinence syndrome occurred in 5.8 per 1000 hospital births. Non-pharmacological labor pain management (NPLPM) is especially recommended for laboring patients with a history of substance abuse. Therefore, literature review was performed to elucidate the efficacy and safety of acupuncture, noninvasive electro-acupuncture (EA), and acupressure in labor pain management. Compared to standard intrapartum controls, bilateral EA at JiaJin or Sanyinjiao significantly reduced visual analog scale (VAS) pain scores 30-minutes post intervention (p < 0.01) and Stage 1 active phase labor length (p < 0.05). EA achieves shorter Stage 2 labor than patient-controlled epidural analgesia (p = 0.05);and 10-point lower VAS pain scores and reduced cesarean delivery rate than no-analgesia controls, p < 0.05. Current evidence indicates that EA should have a role in NPLPM, and that acupressure may have a role in NPLPM. Nevertheless, future RCTs could strengthen the argument for increased EA and acupressure use in NPLPM.

A comparison of maternal fear of childbirth,labor pain intensity and intrapartum analgesic consumption between primiparas and multiparas:A cross-sectional study

Objectives:To describe and compare fear of childbirth and in-labor pain intensity between primiparas and multiparas and explore the association between the amount of actual pain relief and fear of childbirth.Methods:A convenience sampling method was used.A total of 260 women undergoing spontaneous or induced labor,including 97 primiparas and 163 multiparas,were recruited in a large academic specialized hospital in Guangzhou,China,from February 2018 to August 2019.The clinical data of maternal and neonatal were extracted from a structured electronic medical record system.Other demographic information,such as employment and family monthly income,was collected by a questionnaire.The Numeric Rating Scale(NRS)and the Chinese version of the Childbirth Attitude Questionnaire(C-CAQ)were applied to assess maternal in-labor pain intensity and fear of childbirth.The analgesic consumption and the frequency of manual boluses as rescue analgesia were stored and collected from the analgesia pump.Results:Eighty-two(84.5%)primiparas and ninety-nine(60.7%)multiparas received epidural analgesia(P<0.001).In the epidural subgroup,the primiparous average fear of childbirth(36.46±10.93)was higher than that of the multiparas(32.06±10.23)(P¼0.007).However,multiparas reported more intense in-labor pain[8.0(8.0,9.0)vs.8.0(7.0,8.0)],had more successful manual boluses per hour[2.68(1.65,3.85)vs.1.77(0.90,2.47)],more hourly analgesic consumption[23.00(16.00,28.25)vs.17.24(11.52,21.36)mL]and more average analgesic consumption[0.35(0.24,0.45)vs.0.26(0.19,0.35)mL/(h$kg)]than the primiparas(P<0.05).Spearman’s correlation analysis showed that the maximum in-labor pain was weakly positively correlated with fear of childbirth(r¼0.09)(P<0.05),hourly analgesic consumption(r¼0.16)(P<0.01)and average analgesic consumption(r¼0.17)(P<0.05).No statistically significant association was uncovered between analgesic consumption and maternal fear of childbirth.Conclusions:Fear of childbirth is a potential predictor of labor pain intensity.Further study is needed to explore its role and value in pain management during delivery.Parity is not a determinant of pain relief use and should not be a preconceived preference of obstetric care team members to determine the distribution of epidural analgesia,especially when analgesia resources are insufficient.

Midwives’ utilization of nonpharmacological pain relief measures for labor pain management: A descriptive cross-sectional study

Objectives:This study sought to examine midwives’utilization of nonpharmacological pain relief measures in labor pain management and to test the relationship between midwives’knowledge and utilization of nonpharmacological pain relief measures for labor pain management in secondary health facility in Calabar,Cross River State,Nigeria.Materials and Methods:A descriptive cross-sectional design was used for the study.The study was rooted in Katherine Kolcaba’s Comfort theory.Totally,67 participants were recruited for the study using the purposive sampling technique.A self-made structured questionnaire was used to obtain participants’information on knowledge,utilization,and predictors of nonpharmacological pain relief measures.Results:Although 41(61.2%)of the participants had knowledge about nonpharmacological pain relief measures,few did not know some of the cognitive-behavioral and environmental measures in labor pain management.There was 35.8%(24/67)for utilization of cognitive-behavioral measures and 55.2%(37/67)for psychological/emotional measures for labor pain management by respondents,respectively.Fifty(74.6%)of respondents agreed that predictors such as lack of knowledge,lack of updates and training,work experience,best practice guidelines,and equipment were hindrances to utilization.There was statistically significance in relationship between the level of knowledge and utilization of nonpharmacological pain relief measures(r=0.6,P<0.05).Conclusion:The utilization of nonpharmacological measures for labor pain management is low,thus it is recommended that frequent education,training updates on effective labor pain management,provision of clinical guidelines on labor pain management,and enrichment of midwifery training curriculum are imperative to ensure quality labor pain management and positive health outcome.

Level of Labor Pain, Level of Labor Pain Behaviors, and Cultural Pain Behaviors among First-Time Indonesian Muslim Mothers

Background: Many factors influence the expressions of pain in primiparous women aside from contractions of the uterus. Objective: This study aimed to describe the level labor pain, level of labor pain behaviors based on cultural pain behaviors at 3 - 4 cm of cervical dilation or the beginning of the active phase of labor among primiparous Muslim women in Indonesia. Methods: This was a study with 42 primiparous Muslim women who gave birth in the labor room at Bhinneka Bhakti Husada Hospital and Community Health Center Pamulang, Indonesia from June until January 2017. The women were asked to describe on a 100 mm Visual Analogue Scale the intensity of level of labor pain in their abdomen during the last contractions at 3 - 4 cm of cervical dilation, and Pain Behaviors Observation Scale to observe pain behaviors. Descriptive statistics were used to analyze the data. Results: The findings showed that the mean score of level of labor pain at 3 - 4 cm of cervical dilation was 86.38 (SD = 4.47) and most participants experienced high level of labor pain (97.6%). The expression of cultural labor pain behaviors including saying praises to Allah, Asma’aul husna, reciting the Qur’an, sholawat.

Women with Fear of Childbirth Perceived Large Accumulated Labor Pain in Japan

Background: To improve negative birth experiences among women who experience intense labor pain during labor, it is important to examine the relationship between fear of childbirth immediately after vaginal delivery and the actual intensity of labor pain. However, previous studies have generally evaluated labor pain in a retrospective setting. Purpose: This study examined the relationship between fear of childbirth immediately after vaginal delivery and the actual labor pain intensity and accumulated labor pain intensity without pharmacological pain relief during labor in Japan. Methods: A prospective observational study was conducted between July 2015 and April 2016. Forty-seven pregnant Japanese women were available for analysis. Fear of childbirth was measured by the Japanese version of the Wijma Delivery Expectancy/Experience Questionnaire (JW-DEQ) version B on the third day after vaginal delivery. Participants with scores of 85 or higher were categorized in the high JW-DEQ group, having severe fear of childbirth. Labor pain intensity was examined chronologically in real time with stepwise usage of two types of Numeric Rating Scale (NRS). Accumulated labor pain intensity was calculated using the area under the curve (AUC). Results: Nine participants were in the high JW-DEQ group and eight of the nine were primiparae. Primiparae in the high JW-DEQ group experienced significantly longer duration and larger accumulated labor pain intensity between the onset of labor and 4 to 6 cm of cervical dilatation than those in the low JW-DEQ group (P = 0.024 and P = 0.021, respectively). Conclusions/Implications for Practice: The latent phase of labor was a key stage to improve fear of childbirth immediately after vaginal delivery without pharmacological pain relief among Japanese primiparae. Midwives should give assistance in the latent phase of labor by focusing on progressing labor smoothly and relieving labor pain to improve negative birth experiences.

The Safety and Efficacy of Transcutaneous Nerve Stimulation (TENS) in Reducing Vaginal Delivery Labor Pain: Randomized Controlled Clinical Trial

Background: Labor analgesia remains the center of interest for both obstetricians and women. The safety of the traditional pharmacologic analgesics remains questionable due to their potential fetal and maternal complications. Therefore, several non-pharmacological modalities were evaluated for their safety and efficacy to relieve labor pain. Among these methods, transcutaneous nerve stimulation (TENS) gained much concern due to ease of use, low cost and high capacity for women self-titration. The study aims to investigate the efficacy of TENS in reducing labor pain associated with vaginal deliveries, and to determine the factors controlling the response to TENS. Methods: The study was a randomized, controlled clinical trial. A total of 390 women candidates for vaginal delivery were randomly allocated to 3 groups of intervention: paracetamol infusion, TENS, and intramuscular pethidine (130 women per group). The primary endpoint was pain intensity assessed on 10-point VAS scale and women satisfaction. Secondary endpoints included maternal or fetal complications. Results: VAS scores recorded during vaginal deliveries demonstrated a statistically significant reduction in TENS group compared to paracetamol at 15, 30 minutes, 1 and 2 hours, while pethidine arm demonstrated lower scores than TENS group (p < 0.001). The intermediate analgesic efficacy of TENS was preserved when evaluating episiotomy related pain scores. Analysis of differences between good and poor responders to TENS indicated that weight, BMI, education level and the stimulation characteristics were statistically different between the two subgroups (p < 0.001). Adverse maternal and fetal outcomes in TENS arm were comparable to paracetamol and significantly less than pethidine. Conclusion: TENS is a reliable labor pain analgesic with comparable efficacy and superior safety relative to pethidine. Clinicians should personalize TENS therapy according to women’s BMI and education level for optimized pain control.

Labor Pain through the Eyes of Brazilian Women and Delivery Nurses

Objective: Understanding the perception of women who have recently given birth in a Brazilian hospital regarding labor pain and nursing involvement in the labor process. Methodology: exploratory, descriptive and qualitative study carried out in a Maternity part of the supplementary health system in the Federal District (DF). Data were collected between May and July 2015 through interviews using a semi-structured questionnaire. The sample consisted of 16 mothers and data analysis followed Bardin methodology in three phases. Results: The pain experienced during labor is surrounded by feelings and expectations. Both positive and negative feelings experienced by mothers were identified in the interviews and unanimous opinion was the fact that the second stage is the most painful period as continuous pain is experienced. Some of the participants compared pain with strong menstrual cramps, renal colic and back pain;others, said labor pain was the strongest ever experienced. The immediate contact with the newborn was referred to as a reward for coping with breast pain and suffering. Other factors such as the importance of follow-up, support and coping with the pain and care provided by health staff were also highlighted. Conclusion: empowerment of the mother and family through knowledge is considered an important tool to fight pain and cope with the birth process in a positive and physiological way, which in the long run promotes a cultural change in the population regarding the importance of vaginal birth.

Butorphanol in epidural:Could this be the breakthrough solution for safe and effective labor analgesia that we've been waiting for?

The authors have conducted a comprehensive investigation into the safety and effectiveness of butorphanol for epidural analgesia during labor.Their critical analysis of the paper and discussion of the technique's advantages and disadvantages provide a thorough understanding of the topic.

Effectiveness of breathing exercises during the second stage of labor on labor pain and duration： a randomized controlled trial

BACKGROUND： Some research exists on the effect of non-pharmacological approaches for labor pain relief However, there is limited information about effectiveness of breathing exercises in pregnant women to reduce maternal pain during labor. OBJECTIVE： To determine whether breathing exercises for pregnant women during the second stage of labor have beneficial effects on maternal pain, duration of labor, and the first-minute Appearance, Pulse, Grimace, Activity and Respiration （APGAR） scores. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This randomized clinical trial involved 250 pregnant women, who were randomly divided into two groups： intervention group （IG; n = 125） and control group （CG; n = 125）. IG received one session breathing exercise training and performed breathing exercises during the second stage of labor versus the CG that did not receive any breathing exercise training. MAIN OUTCOME MEASURES： The effects of breathing exercises on maternal pain were determined by Visual Analogue Scale （VAS）, duration of the second stage of labor, and the first-minute APGAR scores. RESULTS： The mean age of the participants was （23.2 _＋ 4.2） （range： 18 to 42） years. Both IG and CG had similar baseline characteristics in terms of age, education level, occupation, and smoking （P 〉 0.05）. The mean VAS scores of IG and CG were （88.2 ＋_ 6.3） and （90.5 ＋_ 7.0）, respectively （P 〈 0.001）. The duration of the second stage of labor was （369.6 ＋ 92.0） s for IG and （440.7 ＋ 142.5） s for CG （P 〈 0.001 ）. The mean first-minute APGAR scores were （8.84 ＋ 0.50） for IG and （8.73 ＋ 0.89） for CG （P 〉 0.05）. CONCLUSION： Based on this study, breathing exercises with deep inhalation and exhalation in pregnant women are effective in reducing the perception of labor pain and shortening the duration of the second stage of delivery. Therefore, we recommend breathing exercises as an effective modality for labor pain management and shortening the duration of labor. TRIAL REGISTRATION： This study is registered on the website of ClinicalTrials.gov （www.clinicaltrials.gov） with the number of NCT03066973.

Effectiveness of acupuncture versus spinal-epidural anesthesia on labor pain： a randomized controlled trial

OBJECTIVE: To evaluate the effectiveness of acupuncture analgesia(AA) compared with combined spinal-epidural anesthesia(CSEA) for labor pain relief and labor outcomes.METHODS: We evaluated 131 primiparous women who received respiratory guidance during maternal uterine contractions and received either AA(n =43), CSEA(n = 45), or no additional treatment(control, n = 43). The groups were compared regarding visual analog scale(VAS) scores for abdominal and back pain, and labor outcomes.RESULTS: The abdominal VAS scores of the AA and CSEA groups were significantly lower than that of the control group. In addition, the VAS scores of the CSEA group were significantly lower than that of the AA group at 10 and 60 min after intervention.The back pain VAS scores of the AA and CSEA groups were significantly lower than that of the control group at 5, 10, and 60 min after intervention. The duration of the active phase of labor in the CSEA group was significantly longer than that of the AA and control groups. The rates of oxytocin use(4.70%), urinary retention(4.70%), and postpartum hemorrhage [(273.7 ± 53.6) m L] in the AA group were significantly lower than in the CSEA group [46.70%, 24.20%, and(320.0 ± 85.6) m L, respectively].CONCLUSION: Both AA and CSEA were effective for labor pain relief, CSEA provided more effective pain relief, while AA was associated with a shorter duration of labor and fewer adverse effects.and each has its advantages and disadvantages.

Effect of acupuncture-like transcutaneous electrical nerve stimulation on labor pain in nulliparous women:a randomized controlled trial

Objective To examine the effect of acupuncture-like transcutaneous electrical nerve stimulation(ACUTENS)on labor pain in nulliparous women.Methods This randomized clinical trial was conducted at Razi Hospital in Qazvin,Iran between January and July 2018.After the screening process,144 out of 184 pregnant women were selected by convenience sampling and assigned to an intervention group or a control group by the block randomization method.The intervention group received ACUTENS at Hegu(LI4),Shenmen(HT7),Sanyinjiao(SP6),and Neimadian(Extra)during various stages of delivery in addition to routine labor care at the delivery room.For the control group,the same routine labor care was performed alone.The severity of pain was assessed in the two groups using the visual analog scale(VAS).The data were analyzed using R software(ver.4.0.2)and repeated measurement analysis of variance.Results ACUTENS reduced the mean score of pain intensity in the first stage of labor in the intervention group more than that in the control group(P<0.001).Also,the mean scores of pain intensity in the second stage of labor,episiotomy,and one hour after delivery in the intervention group were significantly lower than those in the control group(P<0.001).Conclusion ACUTENS at Hegu(LI4),Shenmen(HT7),Sanyinjiao(SP6),and Neimadian(Extra)can decrease the intensity of labor pain in nulliparous women.It can be used as a non-pharmacological method for reducing pain in and after labor.

Transcutaneous Electrical Nerve Stimulation on Acupoints Relieves Labor Pain:A Non-randomized Controlled Study

Objective：To investigate the efficacy of transcutaneous electrical nerve stimulation（TENS）on four specific acupuncture points Hegu（LI4）,Neiguan（PC6）,Danshu（BL19）and Weishu（BL21）for reducing pain in labor.Methods：A total of 160 voluntary nulliparous women who were willing to receive TENS for analgesia were assigned to the treatment group after cervical dilation of more than 2 cm.Another 145 matched nullipara were recruited as the control group.Visual analogue scale（VAS）was used to assess the pain before and 0.5 h after the application of TENS.Then,VAS was assessed every one hour until delivery.Percentage of VAS score decreased by〉25%was the primary outcome,the delivery mode and neonatal outcome were measured as secondary outcomes.Adverse reactions were also recorded during TENS.Results：The percentage of VAS score decreased by〉25%was 68.6%in the TENS treatment group.Maternal delivery mode and neonatal outcomes were not significantly different between the two groups.In addition,the incidence of postpartum hemorrhage in the TENS treatment group was less than the control group（P〈0.05）.There was no adverse reaction recorded with TENS on acupoints.Conclusion：As a novel and non-invasive approach,TENS on specific acupoints including Hegu（LI4）,Neiguan（PC6）,Danshu（BL19）and Weishu（BL21）was an effective method for analgesia in labor.

计划行为理论无痛分娩结合接生手法对初产妇分娩出血量、会阴损伤及分娩疼痛的影响

目的:探讨计划行为理论无痛分娩结合接生手法对初产妇分娩出血量、会阴损伤、分娩疼痛的影响。方法:选取2021年8月-2022年7月拟在本院接受无痛分娩的初产妇92例,根据随机数字表法分成干预组与对照组各46例,对照组给予常规分娩护理,干预组给予基于计划行为理论无痛分娩结合接生手法,比较两组出血量、产程、会阴损伤情况、简化版McGill疼痛问卷(SF-MPQ)评分及舒适度。结果:干预组产后2h(185.96±13.47ml)、24h(216.15±21.09ml)出血量均少于对照组(243.11±25.53ml、291.66±29.25ml),第一、二、三产程及总产程短于对照组,会阴损伤情况较对照组轻,SF-MPQ量表视觉模拟评分(3.15±0.88分)、疼痛分级指数(16.32±2.57分)、疼痛强度(1.83±0.45分)均低于对照组(4.67±1.12分、20.81±5.09分、2.47±0.62分),舒适状况量表评分高于对照组(均P<0.05)。结论:实施计划行为理论无痛分娩结合接生手法,能够减少初产妇分娩出血量和会阴损伤,减轻初产妇疼痛,提高身心舒适度。

Introduction of a New Concept of Pain Management during Labor and a Novel Technique for Pain Free Labor

Traditional labor epidural techniques have not been proven to be sufficient to cover the second stage of labor. We have developed a new concept of pain management during labor and a new technique that provides sufficient analgesia for second stage of labor. Combined Spinal Epidural with long lasting saddle block (with hyperbaric tetracaine) was used. Potentially pain free labor could be achieved by using this method. Utilizing hyperbaric Tetracaine intrathecally may provide a long lasting sensory sacral blockade. Primary outcome measure was absence of pain during pushing (2nd stage of labor). Patients received additional comfort during 1st stage of labor. Sample size included all patients that requested labor epidurals since 12/22/11 when this new technique was introduced.

中医穴位按摩联合自由体位对初产妇阴道分娩产程时间及产后出血量的影响

目的:探讨中医穴位按摩联合自由体位对初产妇阴道分娩产程时间及产后出血量的影响。方法:选取2021年6月-2023年6月于本院分娩的初产妇120例,随机分组,其中采用常规分娩模式产妇为常规组,采用中医穴位按摩联合自由体位分娩产妇为联合组,比较两组产程时间及产后出血量。结果:联合组阴道分娩率(91.7%)高于常规组(75.0%),第1产程(356.4±69.0 min)、第2产程(34.5±10.8 min)、第3产程(6.1±1.1 min)时间均短于常规组(442.2±82.6 min、46.1±14.5 min、9.6±1.5 min),分娩时疼痛等级≤2级占比(90.0%)高于常规组(68.3%),分娩控制感评分(178.41±19.68分)高于常规组(121.88±16.54分),产后出血量(208.4±30.0 ml)及分娩时并发症(11.7%)发生率低于常规组(292.5±37.3ml、31.7%)(均P<0.05)。结论:应用中医穴位按摩联合自由体位能够减少初产妇剖宫产率,缩短产程,减轻分娩疼痛,减少产后出血量,降低分娩并发症发生。

分娩镇痛:舒适与安全并行,教学与质控并举

分娩镇痛是以遵循产妇自愿和临床安全为原则,通过实施有效的分娩镇痛技术,以最大程度减轻产妇产痛的医疗服务。2018年,北京协和医院成为我国分娩镇痛首批试点单位,近年来在分娩镇痛高质量发展的各项工作中取得了满意成果。本文主要介绍北京协和医院分娩镇痛相关经验,具体包括:(1)合理调配人员安排,多学科联动制定标准化诊疗流程,为安全分娩提供舒适度保障;(2)完善危重孕产妇、新生儿救治方案,为安全分娩保驾护航;(3)传递先进的教学理念,将分娩镇痛培训与救治演练落到实处;(4)开展教育与科普讲座,帮助产妇树立科学分娩镇痛观。希望该经验分享可为我国各级诊疗机构提供参考和借鉴。

心理弹性支持结合疼痛管理在行水疗助产初产妇中的应用效果

目的 探讨对开展水疗助产的初产妇实施心理弹性支持结合疼痛管理的效果。方法 选择2020年5月至2022年5月百色市人民医院接收的86名初产妇作为研究对象,根据随机数字表法将其分为2组,即对照组和观察组,各43名。对照组在开展水疗助产的基础上实施常规护理,观察组在开展水疗助产的基础上实施心理弹性支持结合疼痛管理。比较2组初产妇在孕期各个阶段的心理弹性、产时疼痛程度、产后2 h出血量、新生儿Apgar评分、分娩控制感、各产程时间,以及护理满意度。结果 观察组在孕中期、孕晚期、分娩后的心理弹性量表得分,以及分娩控制量表评分、各方面护理满意度评分均高于对照组,产时视觉模拟评分法评分低于对照组,产后2 h出血量少于对照组,第一产程、第二产程以及总产程均短于对照组,均存在统计学差异(P均<0.05)。2组间新生儿Apgar评分未见统计学差异(P>0.05)。结论 对开展水疗助产的产妇实施心理弹性支持结合疼痛管理可有效缓解疼痛,减少出血量,提升心理弹性、分娩控制感和护理满意度,缩短产程。

腕踝针对产妇分娩镇痛中爆发痛的影响

目的分析腕踝针对产妇分娩镇痛中爆发痛的效果。方法按随机数字表法将2023年1月—2023年9月江西省妇幼保健院收治的60例初产妇分为对照组和观察组,每组30例。产妇出现爆发痛后,对照组予以罗哌卡因镇痛,观察组在对照组基础上联用腕踝针镇痛。比较2组疼痛程度、心率、平均动脉压、疼痛介质指标、产程时间、不良反应发生情况。结果观察组镇痛30 min、60 min后视觉模拟评分法(VAS)评分均低于对照组(P<0.05)。观察组镇痛60 min后心率、平均动脉压均低于对照组(P<0.05)。观察组镇痛60 min后β-内啡肽浓度高于对照组,5-羟色胺浓度低于对照组(P<0.05)。2组各产程及不良反应发生率对比,差异无统计学意义(P>0.05)。结论腕踝针应用于产妇分娩镇痛中爆发痛效果确切,利于减轻产妇疼痛感、改善心率和平均动脉压,不会对产程造成影响,安全可靠,值得推广应用。

产前AIDET沟通模式联合体验式分娩对产妇产程及应对方式的影响

目的:探讨产前AIDET沟通模式联合体验式分娩对产妇产程及应对方式的影响。方法:选取2020年7月-2022年7月某院产科住院的80例孕晚期孕妇为研究对象,根据入院先后将其分为对照组(n=40,体验式分娩)和观察组(n=40,产前AIDET沟通模式+体验式分娩);比较两组干预前后应对方式[医学应对方式问卷中文版(MCMQ)],产程进展及分娩结局,产后并发症发生情况,新生儿健康状况[Apgar评分]及满意度。结果:干预前,两组MCMQ各维度评分均无显著差异(P>0.05);干预后,观察组面对评分高于对照组(t=4.367,P<0.05),屈服、回避评分低于对照组(t=-7.402,0.297,-4.162;P<0.05)。观察组第一产程、第二产程、第三产程及总产程均较对照组短(t=-6.717,-12.332,-5.314,-7.788;P<0.05);且观察组自然分娩占比高于对照组(67.50%vs 40.00%),剖宫产占比低于对照组(10.00%vs 30.00%)(χ^(2)=7.243,P<0.05)。观察组产后出血、尿潴留、会阴损伤发生率均低于对照组(χ^(2)=3.914,3.914,4.588;P<0.05),两组产后抑郁情况比较,观察组95.00%产妇正常,对照组70.00%正常,30.00%出现不同程度产后抑郁(χ^(2)=8.815,P<0.05)。两组新生儿出生1min、出生5min、出生10min后Apgar评分均无显著差异(P>0.05)。两组满意度比较,观察组为95.00%,高于对照组的77.50%(χ^(2)=5.165,P<0.05)。结论:产前AIDET沟通模式联合体验式分娩效果显著,可使产妇积极应对分娩,缩短各产程及总产程,提高自然分娩率,降低产后并发症及产后抑郁发生率,提升满意度。

可行走性硬膜外分娩镇痛对高龄产妇临床分娩结局及产程时间、疼痛的影响价值分析

目的研究可行走性硬膜外分娩镇痛对高龄产妇的效果。方法选取2021年6月—2023年6月泰兴市人民医院收治的高龄产妇80例为研究对象,采用随机数表法分为。参照组(40例,常规分娩)和研究组(40例,可行走性硬膜外分娩镇痛)。对比两组焦虑自评量表(Self-rating Anxiety Scale,SAS)评分、疼痛数字评价量表(Numerical Rating Scale,NRS)评分、血清皮质醇(Cortisol,Cor)水平、血清泌乳素(Prolactin,PRL)水平、平均动脉压(Mean Artery Pressure,MAP)水平、异常胎心监护事件发生率、催产素使用率、产钳使用率、产程时间、产后出血量、阿氏(Apgar)评分。结果研究组镇痛0.5、1、2 h后的SAS、NRS评分均低于参照组,差异有统计学意义(P均<0.001)。镇痛2 h后,研究组的血清Cor水平较参照组更低,差异有统计学意义(P<0.05)。宫口开全时,研究组血清PRL水平比参照组更高,差异有统计学意义(P<0.05)。研究组宫口开3 cm时、宫口开10 cm时、胎儿娩出时的MAP水平,催产素使用率、产钳使用率,同参照组比较更低,差异有统计学意义(P均<0.05)。研究组母婴不良事件发生率为2.50%,比参照组的15.00%更低,差异有统计学意义(χ^(2)=3.614,P<0.05)。研究组的产程时间比参照组更短,差异有统计学意义(P<0.05)。两组异常胎心监护事件发生率、产后出血量、Apgar评分比较,差异无统计学意义(P均>0.05)。结论将可行走性硬膜外分娩镇痛,用于高龄产妇,可发挥良好的镇痛效果,并缩短产程,临床分娩结局更佳,且安全性良好。