The Effect Of Epidural Analgesia In Labor Analgesia On Maternal And Infant Outcome During Perinatal Period

Objective : In order to explore the safety of the practice of epidural anesthesia in labor analgesia,this project aims to study the analgesic effect of epidural anesthesia during labor and whether it has an impact on the perinatal maternal and fetal outcome.Methods : collect Our hospital From December 2019 to October 2020,the medical records of 1,025 primiparas with conditions for epidural anesthesia and vaginal trial labor.According to the women’s willingness and actual receiving epidural analgesia during labor,they were divided into analgesia group(600 cases)and control area(425 cases).Through the medical record data of the mothers,the general information of the two groups of mothers,the visual analogue pain score(VAS score),the mode of delivery,the course of labor,the rate of transit cesarean section,the maternal and infant outcome and the complications of anesthesia were recorded,and the effects of epidural anesthesia were compared and analyzed.Effectiveness of analgesia and safety to mothers and babies.Results : 1.General information: Epidural analgesia rate is 58.54(600/1025),age,pregnancy time,gestational age,height,weight before pregnancy,BMI before pregnancy,history of pelvic or abdominal surgery in the analgesia group and control group There was no statistically significant difference in the history of adverse pregnancy and pregnancy and pregnancy complications(P≥0.05).2.Analgesic effect: The analgesic effect is evaluated by the visual analogue scale of pain(VAS score).From the line graph,it can be seen that the VAS score of the parturients in the analgesic group decreased from 8 to 3 after using labor analgesia,while the control group The VAS score is more than 8 points lasting,and the difference between the two groups is significant.3.Maternal outcome:(1)The first and second stages of labor in the analgesic group were longer than those in the control group.(2)The use rate of oxytocin and the rate of perineal lateral resection in the analgesic group increased compared with the control group,and the difference was statistically significant(P≤0.05));The rate of transition to cesarean section in the analgesic group was lower than that in the control group(10% vs 16.5%,P≤0.001).Multivariate regression analysis was performed on the two groups of transition to cesarean section.The results showed that age,gestational age,height,pre-pregnancy weight,labor analgesia,birth weight of newborns were related to transition to cesarean section(P≤0.05).(3)There was no statistically significant difference in the rate of postpartum hemorrhage between the two groups(P≥0.05).The multivariate regression analysis of postpartum hemorrhage between the two groups showed that pre-pregnancy weight,third stage of labor,vaginal delivery,and birth weight of newborns were related to postpartum hemorrhage.And it has nothing to do with epidural labor analgesia(P≥0.05),vaginal delivery has the highest risk of postpartum hemorrhage.(4)The incidence of intrapartum fever in the analgesic group was slightly higher than that in the control group,and the difference was statistically significant(P≤0.05).4.Fetal and neonatal outcomes:(1)The rate of amniotic fluid fecal staining in the analgesic group increased(P≤0.05);the results showed that the gestational week of delivery and the time of the first stage of labor,premature rupture of membranes,and vaginitis are potential risk factors for amniotic fluid fecal staining.It has nothing to do with epidural analgesia(P≥0.05);(2)The weight of newborns in the study group is higher than that of the control group,and the difference is significant(P≤0.05);but the Apgar score and umbilical artery blood gas value of the two groups of newborns There is no significant difference.Conclusions : After applying epidural analgesia to the parturient,significant analgesic effects can be achieved.Although the first and second stages of labor are prolonged,they are all within the normal range.The application of epidural analgesia during labor has reduced the transfer rate of cesarean section to a certain extent.Although its use rate of oxytocin,perineal lateral resection rate,intrapartum fever rate,and amniotic fluid fecal staining rate are all increased compared with the control group,it is not There is no negative impact on the outcome of labor.In general,epidural anesthesia is a safe and worthy labor analgesic measure.