A Meta-analysis Of The Effect Of Epidural Analgesia On Maternal And Infant

Background and objects:With the improvement of people's quality of life,epidural analgesia is also continuously accepted by pregnant women.But according to some published studies,epidural analgesia may extend the duration of labor and increase the use of equipment during vaginal delivery,Epidural analgesia also reduces the cesarean section rate of some social factors.But will reduce labor epidural analgesia for pain caused by fear,prolonged labor,fetal distress,and so on a series of factors of cesarean section rate,and the effect on postpartum hemorrhage and newborn Apgar score if there were any,These issues have been controversial since their inception,And it caused quite a lot of attention.In this paper,some related studies on the effects of epidural analgesic delivery on second labor,cesarean section rate,postpartum hemorrhage and neonatal Apgar score were collected,The effects of epidural analgesia on second labor,cesarean section rate,postpartum hemorrhage and neonatal Apgar score were analyzed,To verify the effect of epidural analgesia on these factors,Therefore,it provides instructive meaning for the widespread promotion and application of epidural analgesia.Methods:By computer retrieval Pub Med,Embase,the Cochrane library,the Chinese biomedical literature database(CBM),China journal full-text database(CKNI),wanfang Datebase(CBM),the manual retrieval all current to retrieve the research report and meeting content,incorporated into theoriginal research.The retrieval time limit is controlled to October 2017.Two reviewers independently screened literature,extracted date,and assessed the risk of bias of included studies.Then meta analysis was performed using Rev Man 5.3 software.Results:A total of 24 studies were included in this study.Most of the studies included were retrospective studies,and only a few were prospective studies with blank control groups.Among them,there were 18 studies on the second stage of labor,19 in the study of cesarean section rate and 8 in postpartum hemorrhage,and 19 were related to neonatal Apgar score.Meta analysis results of the studies included,The effect of epidural analgesia on the second stage of labor(MD=-1.16,95%CI-4.85-2.52,P=0.54>0.05);.The effect of epidural analgesia on cesarean section rate in foreign countries(MD=0.81,95%CI0.59-1.11,P=0.19>0.05).Effects on cesarean section rate in China(MD=0.5,95%CI0.37-0.67,P<0.00001).The effect of epidural analgesia on postpartum hemorrhage(MD=0.03,95%CI-2.61-2.66,P=0.98>0.05).Epidural analgesia was the effect of Apgar score <7,i.e.the neonatal asphyxia rate(OR=0.80,95%CI0.65-0.99,P=0.04<0.05).Conclusions:1.Compared with normal vaginal delivery,epidural analgesia have no effect on the second stage of labor.2.Compared with normal vaginal delivery,Epidural analgesia have no effect on cesarean section rate abroad;Epidural analgesia significantly reduce cesarean section rate.3.Compared with normal vaginal delivery,epidural analgesia have no effect on postpartum hemorrhage.4.Compared with normal vaginal delivery,epidural analgesia reduce theincidence of neonatal asphyxia,which is beneficial to Apgar score of newborn.