Influence of fever after delivery analgesia under combined spinal-epidural anesthesia on the delivery outcomes of both mothers and infants
Objective To explore the effect of fever after delivery analgesia with combined spinal-epidural anesthesia on delivery outcomes,so as to improve the outcomes of both mothers and infants.Methods A total of 300 parturients who un-derwent combined spinal-epidural anesthesia during labor analgesia in hospital from January 2020 to June 2022 were selected as research objects.150 parturients who did not experience fever were selected as control group,and 150 parturients who ex-perienced fever were selected as observation group.And then,number of vaginal procedures,time of membrane rupture,to-tal duration of labor,proportion of oxytocin use,mode of delivery,incidence of maternal adverse outcomes,and incidence of adverse neonatal outcomes between the two groups were compared.Results The number of vaginal procedures in the obser-vation group was(7.56±1.12)times,the time of membrane rupture was(11.86±2.03)hours,the total duration of labor was(17.08±2.34)hours,and 51 cases(34.00％)required the use of oxytocin to enhance uterine contractions,while the number of vaginal procedures in the control group was(5.41±1.04)times,the time of membrane rupture was(8.69±1.75)hours,the total duration of labor was(15.04±1.84)hours,and 20 cases(13.33％)required the use of oxytocin to enhance uterine contractions,so differences in the comparison of indexes such as number of vaginal procedures,time of membrane rupture,total duration of labor,proportion of oxytocin use were all statistically significant(P＜0.001).There were 82 cases(54.67％)of spontaneous vaginal delivery,45 cases(30.00％)of cesarean section,and 23 cases(15.33％)of assisted delivery with instruments in the observation group,there were 121 cases(80.67％)of spontaneous vaginal delivery,19 cases(12.67％)of cesarean section,and 10 cases(6.67％)of assisted delivery with instruments in the control group,and difference of comparison of delivery methods between the two groups was statistically significant(P＜0.05 or 0.001).The total incidence of adverse outcomes such as hypotension,headache,postpartum hemorrhage,and pu-erperal infection in the observation group was 60.67％(91/150),and the total incidence of these adverse outcomes in the control group was 31.33％(47/150),so difference in the total incidence of adverse outcomes between the two groups was statistically significant(P＜0.001).The incidence of adverse outcomes such as fetal distress,neonatal asphyxia,neonatal sepsis,and neonatal hyperbilirubinemia in the observation group was 40.67(61/150),and the incidence of these adverse outcomes in the control group was 22.67(34/150),and difference of the incidence of these adverse outcomes between the two groups was statistically significant(P＜0.001).Conclusion Prenatal fever is a clinical manifestation,and early detec-tion and prevention are crucial.For obstetricians,it is necessary to strengthen the management of the labor process,master the indications for vaginal operations,and strictly perform sterile procedures to prevent the occurrence of infectious fever dur-ing labor.Meanwhile,it is necessary to avoid the superposition of factors related to fever during childbirth,and prevent the occurrence of non infectious fever.In addition,it is necessary to comprehensively analyze the causes of fever during labor,dynamically monitor various indicators,carefully identify,and take appropriate measures to handle the production process.
combined spinal-epidural anesthesialabor analgesiapuerperafevermode of deliverymaternal and in-fant outcome
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