| Objective(s):Currently in obstetric epidural analgesia has been widely covered in clinical application,this study intends to explore analysis nature of pregnant women in labor and plan childbirth pregnant women under the use of epidural analgesia after vaginal delivery of maternal and infant outcomes and effect analysis,It provides reference value for the development of obstetrics clinical work and the improvement of obstetrics quality.Methods:From January 31,2022 to January 31,2023,a total of 2585 pregnant women with vaginal delivery in the Obstetrics inpatient Department of the It provides reference value for the development of obstetrics clinical work and the improvement of obstetrics quality.Yunnan Province,including 491 normal full-term primipara,Among them,146 cases with cervical Bishop score ≥6 after 40 weeks of gestation and planned delivery indication before 41 weeks of gestation were assigned to the study group H1,and 156 cases with cervical Bishop score < 6 were assigned to the study group H2.189 cases of natural labor were set as the control group N(pregnant women did not give artificial interference,according to the maternal physiological development of natural labor).The general information of all subjects,postpartum hemorrhage,instrumental delivery,perineal injury,intrapartum fever,VAS pain score15 ’,neonatal Apgar score(1 ’-5’-10 ’)were collected.The neonatal transfer and postpartum B-ultrasound imaging data(urinary retention,intrauterine hemorrhage)were collected.Through pairwise comparison between group N and group H1,and group H1 and group H2 under epidural analgesic labor,maternal and infant outcomes and analgesic effects were observed and analyzed from different perspectives.Results:1.Comparison of general information: age,height,pre-pregnancy weight,BMI and newborn birth weight of primipara in N group and H1 group,H1 group and H2 group,there was no statistical difference among the three groups(P > 0.05).2.Comparison of vaginal delivery and instrumental assisted delivery rates: The vaginal delivery rate of group N was higher than that of group H1,and the instrumental assisted delivery rate of group N was lower than that of group H1,and there was no statistical difference between group N and group H1(P > 0.05).The rate of vaginal delivery in H1 group was lower than that in H2 group,and the rate of instrumental assisted delivery in H1 group was equal to that in H2 group,with no statistical difference between H1 and H2 group(P > 0.05).3.Comparison of perineal integrity,laceration and lateral incision: the integrity rate of group N was higher than that of group H1,the perineal laceration rate of group N was higher than that of group H1,and the lateral incision rate of group N was lower than that of group H1,and there was a statistical difference between group N and group H1(P < 0.05).The integrity rate in H1 group was lower than that in H2 group,the cleft perineal laceration in H1 group was lower than that in H2 group,and the side incision rate in H1 group was lower than that in H2 group,and there was no statistical difference between H1 group and H2 group(P > 0.05).4.Comparison of VAS pain score for 15min: the pain of group N was higher than that of group H1 under epidural analgesia delivery,and there was a statistical difference between group N and group H1(P < 0.05);The pain in H1 group was lower than that in H2 group,and there was a statistical difference between H1 and H2 group(P <0.05).5.Comparison of postpartum blood loss,postpartum fever rate,amniotic fluid fecal staining rate: the amount of postpartum hemorrhage in group N was higher than that in group H1,and there was statistical difference between group N and group H1(P <0.05).The fecal staining rate of amniotic fluid in H1 group was lower than that in H2 group,and there was a statistical difference between H1 group and H2 group(P <0.05).There was no statistical difference in the incidence of fever and meconiumstained amniotic fluid between group N and group H1(P > 0.05).There was no significant difference in the amount of postpartum hemorrhage and the rate of intrapartum fever between H1 group and H2 group(P > 0.05).6.Comparison of neonatal Apgar score 1 ’-5’-10 ’and neonatal transfer: there was no significant difference between N group and H1 group,H1 group and H2 group(P >0.05).7.Comparison of urinary retention(ml)and uterine hemoperitoneum(cm~3): urinary retention in N group was lower than that in H1 group,and there was a statistical difference between N group and H1 group(P < 0.05).In H1 group was higher than that in H2 group,and there was a statistical difference between H1 group and H2group(P < 0.05).And uterine hemoperitoneum in N group was lower than that in H1 group,There was no statistical difference between the N group and the H1 group(P >0.05),In H1 group was lower than that in H2 group,and there was no statistical difference between the H1 group and the H2 group(P > 0.05).8.Multi-factor reg regression analysis showed that maternal weight,lateral perineal incision and midwifery were all positively correlated with postpartum hemorrhage and were risk factors for postpartum hemorrhage.Conclusion(s):1.Under epidural analgesic labor,the proportion of lateral perineal resection in pregnant women with planned labor is higher than that of natural labor.2.Under epidural analgesic labor,there was no increase in the rate of instrumental midwifery for pregnant women with natural labor or planned labor.3.Under epidural analgesic labor,the analgesic effect of pregnant women with planned labor is better than that of pregnant women with natural labor.4.Under epidural analgesic delivery,postpartum bleeding of pregnant women with natural labor is significantly less than that of pregnant women with good cervical maturity during planned delivery;In the population planning to give birth,the amniotic fluid with poor cervical maturity was significantly higher than that of pregnant women with good cervical maturity.5.Under epidural analgesic labor,the urine retention of pregnant women with natural labor and pregnant women with poor cervical maturity during planned labor was significantly less than that of pregnant women with good cervical maturity during planned labor.6.Under epidural analgesic labor,natural labor and planned labor had no effect on the outcome of newborn;It has no effect on Postpartum hemorrhage and Fever during childbirth.7.During epidural analgesic delivery,weight gain,increased perineal lateral resection rate and instrumental assisted delivery of pregant women in this study were all risk factors for postpartum hemorrhage. |
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