The Influence Of Different Methods Of Labor Analgesia On Labor Process And Delivery Outcome

Purpose: To investigate the effect of different forms of analgesia for labor and delivery.Materials and methods: We recruited 236 pregnant women who voluntarily delivered with Doula delivery analgesia combined with a GT-4A instrument between December 2016 and November 2017;these formed an “analgesic delivery group.” In addition,we selected an additional 245 cases of women who received ropivacaine combined with fentanyl patient-controlled epidural analgesia;these formed a “labor epidural group.” We also recruited an additional 260 cases without Doula or without analgesia to form a “vaginal delivery” group.We then compared the three groups with regards to labor time,visual analogue scale(VAS),the rate of cesarean section,uterine atony,fetal distress rate,forceps delivery rate,neonatal asphyxia,postpartum urinary retention,maternal hypotension and bradycardia.Results: First stage and total labor time were significantly shorter in the analgesic instrument delivery group and the labor epidural group than those in the analgesic instrument delivery group(P<0.05).The second stage was significantly shorter in the analgesic instrument delivery group than the labor epidural group(P<0.05),the delivery group was not significantly longer than the control group.There was no significant difference between the analgesic instrument delivery group and the labor epidural group.Visual analogue pain(VAS)score was significantly lower than that of the general delivery group(P<0.05)while the VAS of the Doula delivery group combined with analgesia was significantly higher than that of the epidural analgesia group(P<0.05).The rate of cesarean section and fetal distress was significantly lower in the analgesic instrument delivery group and labor epidural group compared to the general delivery group(P<0.05).The incidence of uterine atony was significantly lower in the Doula combined analgesia group compared to the epidural analgesia group(P<0.05).Compared with the control group,there was no significant difference in the rate of uterine inertia.In addition,there were no significant differences between the three groups with regards to neonatal asphyxia and forceps delivery rate(P>0.05).Finally,the incidence of postpartum urinary retention rate,maternal bradycardia and hypotension were significantly lower in the Doula delivery analgesia instrument group compared to the epidural analgesia group(P<0.05).There were no significant differences in these indexes when compared with the control group.Conclusions: Doula delivery analgesia,combined with a GT-4A instrument,and ropivacaine combined with fentanyl for patient-controlled epidural analgesia,can result in a shortened birth process and can reduce the risk of surgery.In addition,Doula delivery analgesia,combined with a GT-4A instrument,can reduce maternal pain.Although this technique provided only weak levels of epidural analgesia,it significantly reduced the incidence of postpartum urinary retention and other complications when compared to epidural analgesia,and is therefore worthy of attention.