Labor analgesia and its impact on the maternal and perinatal outcomes.

IF 1.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista da Associacao Medica Brasileira Pub Date : 2023-07-17 eCollection Date: 2023-01-01 DOI:10.1590/1806-9282.20230500

Georgeana Debs Guesine, Marina Carvalho Paschoini, Giselle Agreli Melo, Edward Araujo Júnior, Alberto Borges Peixoto

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引用次数: 0

Abstract

Objective: This study aimed to assess adverse maternal and perinatal outcomes in parturients undergoing labor analgesia.

Methods: This was a retrospective cohort study in parturients who underwent labor analgesia. Parturients were categorized into three groups: Group 1 (n=83)-analgesia performed with cervical dilatation ≤4.0 cm; Group 2 (n=82)-analgesia performed with cervical dilatation between 5.0 and 8.0 cm; and Group 3 (n=83)-analgesia performed with cervical dilatation ≥9.0 cm.

Results: Analgesia in parturients with cervical dilatation ≥9.0 cm showed a higher prevalence and a 3.86-fold increase (OR 3.86; 95%CI 1.50-9.87; p=0.009) in the risk of forceps delivery. Analgesia in parturients with cervical dilatation ≤4.0 cm showed a higher prevalence and a 3.31-fold increase (OR 3.31; 95%CI 1.62-6.77; p=0.0016) in the risk of cesarean section. Analgesia in parturients with cervical dilatation ≥9.0 cm was associated with a higher prevalence of fetal bradycardia (20.7%), a need for neonatal oxygen therapy (6.1%), and a need for admission to a neonatal intensive care unit (4.9%). Analgesia in parturients with cervical dilatation ≤4 cm was associated with a higher prevalence of Apgar score <7 at 1st minute (44.6%).

Conclusion: Performing labor analgesia in parturients with cervical dilatation ≤4.0 or ≥9.0 cm was associated with a higher prevalence of adverse maternal and perinatal outcomes.

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分娩镇痛及其对产妇和围产期结果的影响。

研究目的本研究旨在评估接受分娩镇痛的产妇的不良孕产结局和围产期结局：这是一项对接受分娩镇痛的产妇进行的回顾性队列研究。产妇分为三组：第一组（83人）--宫颈扩张≤4.0厘米时进行镇痛；第二组（82人）--宫颈扩张5.0至8.0厘米时进行镇痛；第三组（83人）--宫颈扩张≥9.0厘米时进行镇痛：结果：宫颈扩张≥9.0 cm的产妇进行镇痛的发生率更高，产钳助产的风险增加了3.86倍（OR 3.86; 95%CI 1.50-9.87; p=0.009）。宫颈扩张≤4.0 厘米的产妇接受镇痛的比例较高，剖宫产的风险增加了 3.31 倍（OR 3.31；95%CI 1.62-6.77；p=0.0016）。宫颈扩张≥9.0 cm的产妇镇痛与胎儿心动过缓（20.7%）、新生儿氧疗需求（6.1%）和新生儿重症监护室入院需求（4.9%）的发生率较高有关。对宫颈扩张≤4厘米的产妇进行镇痛与Apgar评分的发生率较高有关：对宫颈扩张≤4.0或≥9.0厘米的产妇实施分娩镇痛与产妇和围产期不良结局的发生率较高有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista da Associacao Medica Brasileira 医学-医学：内科

CiteScore

2.20

自引率

0.00%

发文量

276

审稿时长

12 weeks

期刊介绍： A Revista da Associação Médica Brasileira (RAMB), editada pela Associação Médica Brasileira, desde 1954, tem por objetivo publicar artigos que contribuam para o conhecimento médico.