RESUMEN
Objective:To explore the effect of intraspinal labor analgesia on labor progress, maternal and infant outcomes.Methods:Two hundred cases of full-term singleton primiparous women in head position admitted to the Second Affiliated Hospital of Shantou University Medical College from March 2019 to March 2020 were selected as the research subjects. According to the random number table method, they were divided into the control group (100 cases, natural delivery) and the analgesia group (100 cases, analgesia delivery). The visual analoguescore (VAS), progress of labor, and the outcome of delivery between the two groups werecompared.Results:The VAS scores of the analgesic group at 10, 30 and 60 min after analgesia were lower than those in the control group: (1.30 ± 0.17) scores vs. (9.50 ± 0.53) scores, (0.50 ± 0.22) scores vs. (9.50 ± 0.16) scores, (0.40 ± 0.28) scores vs. (9.50 ± 0.34) scores, the differences were statistically significant ( P<0.05). The first stage of labor in the analgesia group was longer than that in the control group: (347.6 ± 54.4) min vs. (325.8 ± 58.5) min; but the active stage, the second stage of labor, the third stage of labor and the total duration of labor in the analgesia group were shorter than those in the control group: (184.3 ± 39.5) min vs. (202.9 ± 42.7) min, (57.8 ± 17.9) min vs. (85.3 ± 16.9) min, (7.7 ± 5.0) min vs. (16.3 ± 5.2) min, (503.6 ± 131.4) min vs. (596.5 ± 175.7) min, the differences were statistically significant ( P<0.05). The 2 h and 24 h postpartum hemorrhage in the analgesia group were significantly lower than those in the control group: (223.64 ± 80.34) ml vs. (276.97 ± 82.35) ml, (331.57 ± 92.47) ml vs. (384.59 ± 94.25) ml, the differences were statistically significant ( P<0.05). The rate of normal delivery and the use of oxytocin in the analgesia group were higher than those in the control group: 91.0%(91/100) vs. 75.0%(75/100), 83.0%(83/100) vs. 49.0% (49/100), the differences were statistically significant ( P<0.05). In the newborn Apgar scores, the muscle tension, pulse, reflex response, respiration score and total score in the analgesia group were significantly higher than those in the control group ( P<0.05). The neonatal distress in the analgesia group was lower than that in the control group: 4.0%(4/100) vs. 15.0%(15/100), the difference was statistically significant ( P<0.05). Conclusions:Intravertebral labor analgesia can shorten the time of parturient delivery, reduce postpartum hemorrhage, improve the Apgar score of newborns, increase the pregnancy rate, and improve maternal and infant outcome.
RESUMEN
【Objective】 To investigate the effects of atosiban combined with ritodrine hydrochloride on clinical efficacy， serological indicators and maternal and infant outcomes of patients with threatened premature delivery. 【Methods】 A total of 138 patients with threatened preterm delivery in the Department of Obstetrics and Gynecology of The First Affiliated Hospital of Air Force Military Medical University from June 2018 to June 2020 were collected and divided into two groups according to random number table method， with 69 patients in the control group treated with ritodrine hydrochloride and 69 patients in the study group treated with atosiban on the basis of the control group. Clinical efficacy， changes in serological indicators， maternal and child outcomes， and drug safety were compared between the two groups. 【Results】 There were 65 effective cases in the study group （94.20%） and 56 effective cases in the control group （81.16%）. There were statistically significant differences between the two groups （P0.05）. After treatment， timp-1， il-8， il-6， NO and PGE2 levels in the study group were significantly lower than those in the control group （P<0.05）. The success rate of fetal preservation， gestational age， neonatal weight and Apgar score were significantly higher in the study group than in the control group， while the rate of premature delivery was significantly lower than that in the control group （P<0.05）. The incidence of drug-induced adverse reactions （5.80%） was significantly lower in the study group than in the control group （26.09%） （P<0.05）. 【Conclusion】 Atosiban combined with ritodrine hydrochloride can effectively prolong pregnancy， reduce the level of serological indicators， improve maternal and infant outcomes， with fast effect， safe and significant efficacy. Therefore， it is worthy of application and promotion in the treatment of patients with threatened premature delivery.
RESUMEN
Objective To investigate the influence of forceps delivery or emergency cesarean section on the maternal and infant outcome in pregnant women with abnormal second stage of labor.Methods We retrospectively analyzed the clinical data of 118 parturients with abnormal second stage of labor in the department of obstetrics and gynecology in our hospital from 2013 January to 2015 February.The involved parturients with abnormal second stage of labor received different delivery modes including forceps delivery and emergency cesarean section, and the delivery time and its influence on the maternal and infant outcome were compared.Results The mean delivery time of forceps delivery and emergency cesarean section was (14.8 ± 5.3) and (32.7 ± 12.6) minutes, the difference was significant (P＜0.05).The bleeding probability and the occurrence of severe neonatal asphyxia in the forceps delivery group was obviously lower than that of maternal emergency cesarean section group (P＜0.05).The influence of emergency cesarean section on the newborn severe asphyxia was more serious than forceps delivery (P ＜0.05).There was no statistical difference in the mild asphyxia, facial bruising, scalp hematoma and neonatal pneumonia between the two groups.Conclusion Compared with emergency cesarean section, forceps delivery can protect the safety of mother and child can reduce dystocia risk coefficient for the pregnant women with abnormal second stage of labor.