Analysis And Comparison On Different Kinds Of Labor Analgesia Methods Used In Childbirth During Early-foot Parturient

Objective: In this study,we observed that patient controlled sustained epidural analgesia,music analgesia,three groups of doula delivery,labor time,the use of oxytocin in labor,delivery mode,fetal orientation at birth,perineal lateral cutting rate,postpartum 2h hemorrhage,postpartum urinary retention,neonatal asphyxia and cesarean section,caesarean birth rate,etc.Objective to explore the effect of patient controlled epidural analgesia(PCEA)on the mother and infant in the course of childbirth,and to popularize the clinical application.Methods:Choose the women from September 2016 to September 2017,who were obstetric delivery in zhangjiagang first People's Hospital,in to three groups.The implementation of patient controlled epidural analgesia in the early period of maternal(Group A),the same time the implementation of music analgesia delivery of full-term women(Group B),doula accompanying childbirth of term maternity(group C),were excluded from low age and old age(age 18 or > 35 years),non-term,macrosomia,scar uterus,fetal growth restriction,premature rupture of membranes,placenta previa,and severe complications of pregnancy and complication,a total of 188 people into three groups.Group A 77 people,Group B 45 people,Group C 95 people.The differences of analgesic effect,labor time and maternal and fetal outcome in three groups was analyzed retrospectively.Results:1.There were no significant differences in general data on maternal age,height,weight,gestational week,birth weight,etc.in group A,B and C,There was no statistically significant difference in the third stage of labor in three groups(P>0.05).2.Group A 85.71% maternal feeling grade 0 or grade 1 pain,Group B was 13.33%,and Group C was 2.1%,three groups of analgesic effect A group > B group > C group,the difference was statistically significant(P<0.05).3.The average time of the First,second and third stages of labor in Group A was about(560±147)min?(57±12)min?(6±2)min;B Group :(450±118)min?(50±6)min?(5±4)min;C Group :(510±150)min?(53±10)min?(6±3)min.First,second stage of labor time,group A >Group C> Group >B,the difference was statistically significant(P<0.05).There was no statistically significant difference in the third stage of labor in three groups(P>0.05).4.The use rate of oxytocin in Groupa A?B?C was 46.15%?16.22%?17.28%.It was clearly that the use rate in group A was higher than in Group B and C,and the results were statistically significant(P<0.05)while Group B and C had no statistically significant difference(P>0.05).5.A group perineal lateral cut rate was 30.77%;B Group was 54.05%;C Group was 55.56%.The perineal lateral cutting rate in group A was lower than Group B and C,the results were statistically significant(P<0.05),while B group and C Group had no difference.(P>0.05).6.The fetal azimuth anomaly in the fetal delivery time of Group A was 10.77%.0.00% for group B,1,23% for group C.Group A was significantly higher than Group B and C,and the results were statistically significant(P<0.05),while B and C groups had no statistically significant differences(P>0.05).7.The instrument midwifery rate of Group A was15.38%;B Group Was 0%;3.84% for group C.The delivery rate of group A was higher than that in Group B and Group C,and the results were statistically significant(P<0.05),while B and C groups had no statistically significant difference(P>0.05).8.Group A postpartum haemorrhage was 3.08%.postpartum 2 hours average haemorrhage(250±48)ML,neonatal asphyxia rate 0%,postpartum uroschesis rate 0%;group B had 2.7%;(230±70)ML;0%;0%.Group C had 1.23%;(236±78)ML;0%;2.47%.There was no statistically significant difference in postpartum hemorrhage rate,postpartum 2h hemorrhage,neonatal asphyxia rate and postpartum urinary retention rate(P>0.05).9.The Caesarean section rate of cesarean section in Group A was 14.74%,and there was no statistically significant difference between the three groups(P>0.05)in the 17.78%;C Group(15.58%;B).There were no statistically significant differences in the reasons for Cesarean section(P>0.05)in three groups.Conclusion:1.Patient controlled epidural analgesia can significantly reduce the pain of childbirth,but the extension of the first and second stage of labor time,increase the application of oxytocin,increase the fetus when abnormal fetal position,increase the rate of vaginal delivery,but reduce episiotomy rate.It does not increase the rate of cesarean section,and does not increase postpartum hemorrhage and neonatal asphyxia.Although patient-controlled epidural analgesia is invasive,it has a good analgesic effect and no effect on maternal and fetal outcomes.If there is no contraindication of puncture in the spinal canal and voluntary acceptance,it can be a good experience of childbirth,and is worthy of clinical promotion.2.Music analgesia delivery can relieve pain of childbirth to some extent,and non invasive operation can accelerate the labor process,do not affect the outcome of the mother and child.It is recommended for those who cannot or do not want to perform Patient controlled epidural analgesia.3.The analgesic effect of Doula delivery is the worst.But it encourages free parturition in the course of birth,promotes the birth process and can be used in combination with other methods of analgesia.