Abstract
This paper aimed to analyze the analgesic effects of continuous epidural labor analgesia (ELA) at different periods and its effects on postpartum depression, maternal and infant outcomes, and maternal blood pressure. Giving birth in our hospital from September 2017 to August 2019, 119 primiparas with spontaneous delivery were enrolled and divided into an observation group (65 cases) and a control group (54 cases). Patients in the observation group received epidural block analgesia in advance, whereas those in the control group received epidural block analgesia routinely. At 25 days after delivery, breast milk samples were collected, in which miRNA-146b level was detected by PCR. The patients were compared between the two groups with respect to progress of labor, analgesic effects during 3 stages of labor, labor outcomes, adverse reactions, and levels of NO, ANP, and ET-1 in the parturients' umbilical artery blood. Compared with those in the control group, patients in the observation group had a remarkably higher miRNA-146b level in the breast milk (P < 0.05), remarkably lower average Visual Analogue Scale (VAS) scores during the active phase and the second stage of labor (P < 0.05), and remarkably higher levels of NO, ANP, and ET-1 (P < 0.05). There were no statistically significant differences in adverse reactions and modes of delivery between the two groups (P < 0.05). ELA starting from the latent phase can improve the miRNA-146b level in maternal breast milk, alleviate labor pain of parturients, and shorten stages of labor. Therefore, our study is worthy of clinical promotion. We still need to do more experiments and use more data to conclude more scientific results in future research work.
Highlights
During delivery, parturients experience uterine contraction (UC) induced pain, which causes hemodynamic changes and negative emotions
With the development of medicine, it is generally believed that childbirth without pain (CWP) is helpful to improve the feeling of childbirth and pregnancy outcomes [1,2], so the way to relieve parturients’ pain during delivery and prevent it has been become an important evaluation indicator for measuring delivery quality a research direction of modern obstetrics [3,4]
Previous views held that the late latent phase or early active phase (3-4 cm of the cervix) of stages of labor is a relatively suitable time for labor analgesia, which is rarely used in the early latent phase, but this view has not been clearly verified because the stimulation of pain in the latent phase brings adverse effects on mothers and infants [6,7]
Summary
Parturients experience uterine contraction (UC) induced pain, which causes hemodynamic changes (such as increases in heart rate and blood pressure) and negative emotions (such as anxiety). Patient-controlled epidural analgesia (PCEA) is widely used during delivery due to its good analgesic effect and mild motor block, with its application in developed countries of 61%–75% [5]. Ey are recently found expressed in human milk and other body fluids, with immune-related miR-146b. MiRNAs in human milk can tolerate the acid environment and enzymolysis of the gastrointestinal tract, suggesting that they may be directly absorbed by infants and involved in their immune regulation [8]. E component of human milk is affected by maternal factors (such as mother’s age, nutritional status, pregnancy complications, and modes of delivery) and infant factors [10,11]. Erefore, we observed immune-related miR-146b expression in human milk for epidural labor analgesia (ELA) at different periods in this study MiRNAs in human milk can tolerate the acid environment and enzymolysis of the gastrointestinal tract, suggesting that they may be directly absorbed by infants and involved in their immune regulation [8]. e component of human milk is affected by maternal factors (such as mother’s age, nutritional status, pregnancy complications, and modes of delivery) and infant factors [10,11]. erefore, we observed immune-related miR-146b expression in human milk for epidural labor analgesia (ELA) at different periods in this study
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