硬膜外分娩镇痛产时发热程度对母儿围生结局的影响

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中图分类号：R714.3 文献标志码：A DOI：10.11958/20250020

Abstract： Objective To investigate the impact of different degrees of fever during epidural labor analgesia on maternal and neonatal perinatal outcomes. Methods A retrospective analysis was conducted on 240 pregnant women who received epidural labor analgesia. Based on the peak temperature during labor， the participants were divided into the control group （ <37.3∘C ， 160 cases）， the A group （37.3 to <38∘C ， 55 cases） and the B group ， 25 cases）. The differences in maternal prenatal data， labor progression and neonatal outcomes were compared between the three groups. Results There were no significant differences in mode of delivery， onset of labor and membrane rupture method between the three groups P>0.05 ）. The time interval from the initiation of epidural analgesia to delivery and the time from membrane rupture to delivery were longer in the A group and the B group compared to the control group P<0.05 ）. Among women who delivered vaginally， the first stage of labor was longer in the A group and the B group compared to the control group （ P< 0.05 ）， and the second stage and total duration of labor were longer in the A group than those in both the control group and the B group （ P<0.05 ）. There were no significant differences in neonatal Apgar scores， birth weight， umbilical blood pH and the incidence of neonatal complications between the three groups P>0.05 ）. Conclusion Longer epidural analgesia duration and a prolonged first stage of labor may increase the risk of labor-associated fever. Higher degree of fever during labor promotes more active intervention in the second stage of labor， but it does not significantly affect neonatal outcomes.

Key words： analgesia， epidural; parturition; epidural-related maternal fever; perinatal outcomes

椎管内分娩镇痛技术极大程度上降低了产妇阴道分娩时的剧烈疼痛，其中硬膜外分娩镇痛是目前应用广泛且安全有效的一种椎管内分娩镇痛方式［1-2］。（剩余8349字）