Abstract：Objective To evaluate the effects of transcutaneous electrical nerve stimulation ( TENS ) and waterbirth with Doula services on the outcome of delivery. Methods From July 2018 to December 2019, 150 primiparas in Hangzhou Women's Hospital were randomly divided into three groups: TENS, waterbirth and control groups. They were given TENS, waterbirth and conventional midwifery, accompanied by Doula services. The visual analogue scores ( VAS ) , length of labor stages and neonatal asphyxia were compared. Results It finally included 45 cases in the TENS group, 45 cases in the waterbirth group and 44 cases in the control group. There were no significant differences in gestational weeks, age, height, weight, fetal biparietal diameter and newborn birth weight among the three groups ( P>0.05 ) . The VAS scores of TENS group and waterbirth group were lower than those of the control group ( P<0.05 ) , but there were no significant differences between the two groups ( P>0.05 ) with the cervix open to 2.5-3 cm, 5-7 cm ( 0.5 hours later ) and 10 cm. There was no interaction between the analgesia methods and cervix diameter ( P>0.05 ) . The duration of the first stage of labor in the TENS group and the waterbirth group was less than that in the control group ( P<0.05 ) , and there was no significant difference between the TENS group and the waterbirth group ( P>0.05 ) . The asphyxia rate of neonates in TENS group, waterbirth group and control group were 2.22%, 2.22% and 4.55%, respectively, with no significant difference ( P>0.05 ) . Conclusion Under Doula services, both TENS and waterbirth can effectively relieve the pain of delivery and shorten the first stage of labor, without obvious differences.
[1] SMITH C A,LEVETT K M,COLLINS C T,et al.Relaxation techniques for pain management in labour[J/OL].Cochrane Database Syst Rev,2018(3)[2020-06-09].https://doi.org/10.1002/14651858.CD009514. [2] 李媚娟,徐琼,李妹燕.分娩疼痛机制与常用分娩镇痛方法[J].国际妇产科学杂志,2018,45(2):125-129. [3] 刘嘉,邱迪,谭萱,等.经皮神经电刺激分娩镇痛的疗效观察[J].暨南大学学报(自然科学与医学版),2016,37(5):416-419. [4] 查锦芬,宋华梅,毛巧玲.水中分娩对低风险产妇围产期妊娠结局的影响[J].中国妇产科临床杂志,2019,20(3):249-250. [5] THOMAS M P,AMMANN G,BRAZIER E,et al.Doula services within a healthy start program:increasing access for an underserved population[J].Matern Child Health J,2017,21(2):59-64. [6] AHLEMEYER J,MAHON S.Doulas for childbearing women[J].MCN Am J Matern Child Nurs,2015,40(2):122-127. [7] 黄川雅,姜梅,徐鑫芬,等.导乐陪伴分娩开展现状的调查[J].中华护理杂志,2019,54(11):1673-1676. [8] 龙波,孙唯韦,肖甄男,等.超声引导下腹横肌平面阻滞和切口局麻药浸润在腹腔镜胆囊切除术后镇痛效果的比较[J].中国医科大学学报,2017,46(8):694-697. [9] 汤征宇. 基于激光诱发电位的经皮神经电刺激的镇痛机制研究[D].重庆:西南大学,2018. [10] SANTANA L S,GALLO R B S,FERREIRA C H J,et al.Transcutaneous electrical nerve stimulation(TENS)reduces pain and postpones the need for pharmacological analgesia during labour:a randomised trial[J].J Physiother,2016,62(1):29-34. [11] 李莉,吕艳,翟翔隽,等.经皮神经电刺激用于分娩镇痛的临床研究[J].国际妇产科学杂志,2018,45(1):37-40. [12] 张凌云. 分娩镇痛下分娩球运动配合自由体位对产程及分娩结局的影响分析[J].中国基层医药,2016,23(16):2450-2453. [13] 张莉莉. 水中分娩对孕妇分娩质量的影响研究[J/CD].实用妇科内分泌电子杂志,2019,6(26):125-132. [14] 李海燕,郑旭萍,陈红,等.水中分娩对孕产妇产程的影响[J].预防医学,2017,29(1):98-100. [15] BEAL J,SHAW-BATTISTA J,HUWE V Y.Should water birth be offered as an option for childbearing women?[J].MCN Am J Matern Child Nurs,2015,40(4):210-211. [16] 刘金玲,徐捷,陈丹,等.产妇水中分娩体验的质性研究[J].护理学杂志,2018,33(24):20-22. [17] NEIMAN E,AUSTIN E,TAN A,et al.Outcomes of waterbirth in a US hospital-based midwifery practice:a retrospective cohort study of water immersion during labor and birth[J].J Midwifery Womens Health,2020,65(2):216-223. [18] 牛春月,田菲,孔秀丽,等.低频脉冲电刺激结合中医经络理论在分娩镇痛中的应用研究[J].中国妇幼健康研究,2017,28(2):43-44.
