Meta-analysis Of The Effect Of Epidural Anesthesia On The Delivery Process And Maternal And Infant Outcome Of Primipara

Objective:To systematically evaluate the effects of epidural anesthesia on the delivery process and maternal and infant outcomes of primiparas,and provide evidence-based evidence for the implementation of clinical epidural analgesia in labor.Methods:A computer search of all relevant clinical randomized controlled trials of the effects of epidural anesthesia on the birth process and maternal and infant outcomes of primiparas in the Chinese National Knowledge Base,Wanfang Database,Pub Med English Database,Cochrane Library English Database,Web of Science and Chinese Biomedical Literature Database(RCTs),use Note Express software for preliminary data screening,and then through intensive reading of the full text,screen out documents that meet the inclusion criteria,conduct bias risk assessment,quality evaluation,and extraction of result index data for the final included documents,and use Revman 5.4 software Perform Meta analysis.Results:There are a total of 15 final documents that meet the inclusion criteria,and a total of 2728 cases were included.Among them,1367 cases were given epidural anesthesia for labor analgesia,and 1361 cases were in the control group.Metaanalysis results showed that compared with the control group,the delivery analgesic group under epidural anesthesia could significantly reduce labor pain(RR=3.97,95%CI=2.38～6.62,P<0.00001)and shorten the first stage of labor(SMD=-1.71,95%CI=-2.37～-1.05,P<0.00001),shorten the second stage of labor(SMD=-0.43,95%CI=-0.8～-0.06,P=0.02),shorten the total stage of labor(SMD=-1.86,95%CI=-2.24～-1.49,P<0.00001),reduced the incidence of cesarean section(RR=0.30,95%CI=0.24～0.37,P<0.00001),the difference was statistically significant.The two groups of postpartum hemorrhage(SMD=-0.35,95%CI=-0.77～0.66,P=0.09)and newborn 1min Apgar score(SMD=0.04,95%CI=-0.08～0.15,P=0.56)compared,The differences were not statistically significant.Conclusion:Epidural analgesia during labor can effectively relieve labor pain,shorten labor,reduce the rate of cesarean section,and will not increase the risk of postpartum hemorrhage and neonatal asphyxia.It has certain safety and effectiveness and is worthy of clinical application.