ABSTRACT
Objective To compare the safety and efficacy of whole stage and first stage of labor analgesia on puerperas with pregnancy-induced hypertension syndrome.Methods From March, 201 5 to November,201 5,1 96 single fetus,aged 22-35 years,term pregnancy,primipara,ASA physical status Ⅰ or Ⅱ, diagnosed pregnancy-induced hypertension syndrome, were randomly divided into the whole stage of labor analgesia group (group T)and the first stage of labor analgesia group (group F).Patients in group T received labor analgesia after uterine contractions regularly,and continued the labor analgesia to the end of the delivery;patients in group F received labor analgesia after uterine contractions regularly and the uterus cervix was 3 cm,in the end of the first stage of la-bor,using the normal saline instead of the medicine.The MAP and VAS score were recorded before analgesia and 10 minutes,60 minutes after the beginning of analgesia,when the uterine cervix dilated absolutely,the second stage of labor and when the fetal is delivered.The Bromage scores were recor-ded at the second stage of labor.The time for the first stage of labor,the second stage of labor and the third stage of labor were recorded.The mode of delivery,the incidence of eclampsia,postpartum hemorrhage,the use of oxytocin and antihypertensive in the delivery progress were recorded.The ne-onate weight,Apgar score and the cord blood gas analysis were recorded.Results At the uterine cer-vix dilated absolutely and the second stage of labor,the MAP [(106.0±7.0)mm Hg vs.(1 1 5.4± 7.3)mm Hg,(106.2 ± 7.2 )mm Hg vs.(1 1 6.0 ± 7.6 )mm Hg]and VAS score [(2.0 ± 1.1 ) scores vs.(5.1±1.2)scores,(1.9±1.2)scores vs.(5.2±1.3)scores]in group T were lower than those in group F (P <0.05).The patients who received oxytocin in group T were more than that in group F [50(5 1%)vs.35(35%),P <0.05].Conclusion The whole stage labor epidural analgesia is safe and effective for puerperas with pregnancy-induced hypertension syndrome.
ABSTRACT
Objective To investigate the distribution ofβ2-adrenergic receptor (β2-AR)genetic polymorphisms among the included parturient women and observe the relationship between the genetic polymorphisms and labor progress after labor analgesia.Methods A prospective observational study was conducted from March to June in 2014 at Nanjing Maternity and Child Health Care Hospi-tal.A total of 1 65 nulliparous women were enrolled in the study,and finally 1 52 patients were includ-ed after exclusion for several reasons.Theβ2-AR gene polymorphic variations at nucleotides encoding amino acids 1 6 and 27 were detected by polymerase chain reaction-restriction fragment length poly-morphism technique.And the demographic data,rate of oxytocin usage,length of labor progress and the incidence of cesarean section after labor analgesia were observed and recorded.Results The allele frequencies ofβ2-AR genetic polymorphism in the parturient women were dominantly presented in the form of Arg1 6Arg (AA)and Arg1 6Gly (AG)at 1 6 position and Gln27Gln(CC)at 27 position respec-tively.The demographic and background characteristics of the subjects didn’t present any significant differences among the groups with differentβ2-AR genetic polymorphism.And the differences of labor progress among β2-AR 27 genetic polymorphisms parturient women were not significant.However, the length of the first stage and the total labor progress in the β2-AR Arg1 6Arg homozygous were both significantly longer than that in the other two groups (P <0.05),and the incidence of cesarean section was also significantly higher (P <0.05 ).Furthermore,we also found that β2-AR Arg1 6Arg homozygous was related to cesarean delivery after labor analgesia through multivariate logistic regres-sion analysis (OR 2.87,95%CI 2.69-3.09).Conclusion The labor progress of the parturient women with β2-AR Arg1 6Arg homozygous is relatively slower,which maybe an important risk for the nullip-arous women transforming to cesarean delivery after labor analgesia.
ABSTRACT
OBJECTIVE: We evaluated the effects of epidural analgesia on labor progress and perinatal outcomes in nulliparous women. METHODS: Between June 2004 and December 2004, we included total one hundred and thirty-two normal near term nulliparous women in early spontaneous labor or rupture of membranes for a prospective analysis. Patients were divided into those who received epidural analgesia (study group n=66) and those who did not (control group n=66). In order to evaluate the effects of epidural analgesia on labor progress, we compared the duration of active phase of labor and second stage of labor, cervical dilatation on admission, Bishop score and labor interval between the groups. We also compared perinatal outcomes between the two groups. RESULTS: The duration of active phase of labor was 4.7+/-2.0 hours in the study group and 3.6+/-1.9 hours in the control group showing a statistically significant prolongation in the duration of active phase of labor and significant slowing in the rate of cervical dilatation (p<0.05). The second stage of labor was also prolonged slightly in the study group (65.1+/-39.0 minutes) compared to the control group (54.1+/-33.5 minutes) but no statistical significance was noted. There was no significant difference in perinatal outcomes. CONCLUSION: Epidural analgesia may prolong active phase of labor. Therefore, we should always consider the effect of epidural analgesia before we decide to perform cesarean section.