Objective To evaluate the effect of music therapy for childbirth. Methods Such databases as The Cochrane Library, PubMed, EMbase, EBSCO host, SpringerLINK Online Journals, CBM and WanFang Data were searched from January of 2000 to December of 2010 to collect randomized controlled trials (RCTs) of music therapy for childbirth. The quality of RCTs was appraised and the data were extracted. Meta-analyses were conducted with RevMan5.02 software for the standarded RCTs. Results A total of nine RCTs were included. Five RCTs indicated the music therapy could alleviate the labor pain; five RCTs indicated the music therapy could reduce the event risk of cesarean section due to the failure of transvaginal trial labor; three RCTs indicated the music therapy could shorten the first stage of labor; two RCTs indicated the music therapy could stabilize the systolic pressure and heart rate when complete cervical dilation was done, and three RCTs indicated the music therapy could relieve anxiety. In addition, music therapy had no influence on neonate Apgar’s score; and the result of meta-analyses on postpartum hemorrhage was not reliable through sensitivity analyses. Conclusion The music therapy applied during childbirth can relieve the labor pain and anxiety, stabilize the heart rate and systolic pressure when complete cervical dilation is done, reduce the event risk of cesarean section due to the failure of transvaginal trial labor, shorten the first stage of labor, and is beneficial to the mind and body of parturient.
目的 探讨体位指导对产程的影响。 方法 选择2007年1月-2008年1月产科住院的经特殊体位管理分娩的260例产妇，作为观察组；同期未予以体位指导的经阴道分娩的260例产妇作为对照组，产程中未作体位指导，一般以平卧为主。观察两组产程进展情况、胎儿宫内窘迫、剖宫产率等。 结果 观察组与对照组相比，第1产程及第2产程明显缩短，胎儿宫内窘迫、剖宫产率明显降低，有统计学意义（P＜0.05）。 结论 对孕妇实行体位管理能加快产程，避免各种产科并发症的发生，增加了阴道分娩率，减少了剖宫产率。
ObjectiveTo investigate the factors affecting the results of vaginal birth after cesarean (VBAC). MethodsWe retrospectively analyzed the data from 80 pregnant women of prior cesarean section with intention of vaginal delivery between October 2012 and July 2013. According to the final way of delivery, the 80 women were divided into two groups, the VBAC group (40 cases) and repeated cesarean section (RCS) group (40 cases). The clinical characteristics of the two groups were compared and further multi-variant analysis was conducted. Besides, 40 women with successful repeated vaginal delivery were included as controls. The delivery time and bleeding volume were compared between the VBAC group and the control group. ResultsThe three determinant factors associated with the present VBAC were: Arrested labor as the indication of prior cesarean section [OR=1.601, 95%CI (1.025, 2.469), P=0.04], Bishop Score [OR=3.757, 95%CI (1.437, 8.772), P=0.01] and infant weight [OR=1.391, 95%CI (1.124, 2.583), P=0.03]. The VBAC group presented a higher Episiotomy rate than the RCS group. No significant difference was found between the VBAC and the control group regarding the delivery time [(6.71±2.94) vs. (5.88±2.47) hours, P=0.176] and bleeding volume [(259.13± 75.31) vs. (230.36±67.44) mL, P=0.076]. ConclusionVBAC presents a better and faster recovery with a shorter hospital stay. But the indication of VBAC should be strictly followed to ensure the safety of both mothers and babies.
Objective To explore the effects of utilization of new partogram on the progress of labor and intervention in the labor. Methods We reviewed nulliparous women who had vaginal delivery at our hospital from January 1st, 2015 to December 31st, 2017. They were divided into control group (group A) (n=200; the old labor standard was used during this time) and observation group (the new labor standard was used at the same time). The observation group was sub-divided into group B (n=100, the duration of dilatation of cervix from 0 to 3 centimeters greater than or equal to 16 hours after parturition), group C1 [n=100; the second-stage duration (t) was greater than or equal to 2 hours, and less than 3 hours), and group C2 (n=100; t was greater than or equal to 3 hours). We compared the differences in intervention at the stages of labor such as using oxytocin to strengthen the contractions, artificial rupture of membranes, using phloroglucinol to soften the cervix, urinary catheterization, and manual rotation of fetal head among the groups. We also compared the differences in fetal presentation position, head tumor, fetal position, cephalopelvic disproportion and progress of the drop when the dilatation of cervix get to 10 centimeters among the groups. Results In the comparison among group A, B, C1 and C2 in rates of using oxytocin to strengthen the contractions, using phloroglucinol to soften the cervix, urinary catheterization and manual rotation of fetal head, the differences were statistically significant between group C2 and the other groups (P<0.008 5). The differences among group C1, C2 and A were statistically significant in duration of the first stage of labor (P<0.05). The same result was found between group B and A in duration of the second stage of labor (P<0.05). In the comparison of the different ratios of fetal presentation position between group A and C1, and group A and C2, when the dilatation of cervix get to 10 centimeters, the differences were significant (P<0.017), except at +1 position. The differences in whether the fetal presentation was producing head tumor and occipital anterior position among group A, C1, and C2 were statistically significant (P<0.017), but there was no difference between group A and C1 (P>0.017) in occipital anterior position. In the comparison of the different progress of the drop when the dilatation of cervix had got to 10 centimeters, 0–1 hours: the differences were statistically significant among group A, C1, and C2 (P<0.05) ; 1–2 hours: the difference was statistically significant between groups C1 and C2 (P<0.05). In group C1, there was a statistically significant difference between 0–1 hour and 1–2 hours (P<0.05). In group C2, there was no statistically significant difference among 0–1 hour, 1–2 hours and 2–3 hours (P>0.05). Conclusions According to the new labor standard, the rates of intervention in the labor would not increase, but when the second-stage duration is greater than or equal to 3 hours, the frequency would increase. We should deal with the abnormal factors affecting labor in time, and try to control the duration in 3 hours.