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...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.展开更多
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 Qazvi...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.展开更多
文摘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.
文摘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.
