- Sinh viên 1.1 1.1.1 1.1.2 Nguyên nhân 1.1.3 1.1.4 1.1.5 1.1.6 1.1.7 1.2 1.2.1 1.2.2 : 16 2.1 16 2.2 16 2.3 16 2.4 16 2.5 16 2.6 16 2.7 X 2.8 16 17 2.8.1 18 2.8.2 19 20 3.1 20 Thang Long University Library 3.1.1 20 3.1.2 20 3.1.3 21 3.1.4 21 3.2 22 3.2.1 22 3.2.2 23 3.2.3 23 3.2.4 24 3.2.5 24 3.2.6 24 3.2.7 25 3.2.8 25 3.2.9 26 3.3 26 27 27 27 27 27 28 28 28 4.2 30 30 31 32 4.2 32 34 34 35 38 3.1:Tu i s n ph 3.2:Tu i thai hai nhóm nghiên c u 20 hai nhóm nghiên c u 20 3:Phân b ngh nghi p 21 22 23 3.6:T l truy n oxytocin 3.7:Th i gian s thai hai nhóm 24 hai nhóm 24 B ng 3.8: Th i gian chuy n d 3.9:Tác d ng ph c a GTNMC 25 3.10:M phong b v 3.11:Ch s Apgar c a tr ng nhóm GTNMC 26 26 T 18 Phân b v ns 21 23 25 Thang Long University Library 45] Mang thai 42], [43], [49 60], [32 suy thai [20], [35], [39] 19], [43] Tác gây tê màng B T gây tê màng 2 Thang Long University Library 1.1 1.1.1 1.1.2 Nguyên nhân 1.1.2.1 Prostaglandin thai 1.1.2.2 Estrogen progesteron ng, 1.1.2.3 1.1.2.4 kích 1.1.3 1.1.4 - - Trung bình 20 phút - - 30 phút [13], [16] Thang Long University Library 1.1.5 1.1.5.1 - - 30 13], [16] 1.1.5.2 16] 1.1.6 - - 100 57] 1.1.7 1.1.7.1 39] - L1 [6], [37], [39] - S4 [6], [37], [39] thơng hóa - - [6], [37], [39] 1.1.7.2 thai nhi: - [20], [32], [35], [34], [0] : Thang Long University Library Tuy n Ib + 82 480 phút 5], [4], [8 Có GTNMC Khơng GTNMC p Decca 254 251 >0,05 Sandro 300 292 >0,05 Caruselli 413 396 >0,05 Hendrick 198 416 < 0,02 31 GTNMC 7,99 + 5,133 phút n 23], [28], [33]: GTNMC (phút) Decca Hendrik Caruselli 44 38,8 100,5 Decca 23], [28], [52]: Có GTNMC Sandro 12,9 Caruselli 8,4 Decca 11 32 Thang Long University Library [56] Trong nghiê 28], [33], [50] Có GTNMC Decca Hendrik 24,2 Richmond 30,1 14] 26 21], [57 33 nhi 4], [56 gian kéo dài GTNMC [56] 34 Thang Long University Library MC 7], [29], [37 nghiên GTNMC 4], [10], [38 > Apgar sau phút/5 phút >7 35 3], [4], [10], [28], [36], [46] SpO2 22], [28], [36], [40] 24 an toàn cho thai nhi 36 Thang Long University Library KÊT LU N 314 chúng cao cao Không làm 7,9% ng (9,9%), 1,9%) > 37 38 Thang Long University Library , Nhà - 400 - 92 , 108 - 116 - , 65 - 74 - , 45 - 64 - 57 10 , 141 - 145 11 - Bài - 83 12 2004 - 2005 13 - 16 14 15 16 Bài gi - 96 17 Br J Obstet Gynaecol, 92, 1246 - 1250 18 Eur J Anaesthesiol, 20(9), 682 689 19 Drugs, (41), 69 - 80 20 Br Eur J Obstet Gynecol Reprod Biol, (59), 99 21 epidural in labour does it increase the incidence of spontaneous deli Journal of Obstetrics and Gynaecology, 8, 258 - 261 Thang Long University Library 22 The journal of maternal - fetal and neonatal medicine, 20(2): 161 - 165 23 The journal of maternal - fetal and neonatal medicine, 24(2), 250 - 252 24 epidural analgesia is independent The journal of maternal - fetal and neonatal medicine, 45, - 25 Clin Obstet Gynecol, (30), 515 - 529 26 Christine L, Charles S.A, Carolyn A.C (2005), -analysis of upright positions in the second stage to reduce instrumental delivery in women with Acta Obstet Gynecol Scand, 84, 794 - 798 27 Am J Obstet Gynecol, 91, 10 - 17 28 d delivery in epidural analgesia: a case- The journal of maternal - fetal and neonatal medicine, 16, 115 - 118 29 satisfaction with childbirth and interpartum analgesia in nu Aust NZJ Obstet Gynaecol, 43, 403 - 408 30 ASA newsletter (93) 31 stage of labour following epidural Journal of Obstetrics and Gynaecology, 4, 40 - 43 32 Eisenach JC; Pan PH; Smiley R; Lavand'homme P; Landau R; Houle TT predicts persistent pain and postpartum depression Pain (140), 87- 94 33 Acta Obstet Gynecol Scand, 73, 235 - 239 34 livery decrease the risk of postnatal depr Acta Obstet Gynecol Scand, (83), 257 - 61 35 , Obsteric anesthesia: principles and practice, 288 - 300 36 Acta Obstet Gynecol Scand, 79, 336 - 340 37 new England journal of medicine, (363), 1503 - 1010 38 Pain manag nurs, 9(1), 10 - 16 39 Am J Obstet Gynecol, (186), 16 - 24 40 Matouskova A, Dottori O, Forssman L (1979), Acta Obstet Gynecol Scand, 83, - 13 41 Acta Obset Gynecol Sacnd, 54, 401 - 406 42 Can Med Assoc Journal, (4), 357 - 63 43 Pain, (19), 321 337 44 Br Med J, 396 - 400 45 46 Acta Obset Gynecol Sacnd, 55, 305 - 310 Thang Long University Library 47 women during labor with or without epidural analgesia: a prospective Acta Obset Gynecol Sacnd, 81, 1033 - 1039 48 Ralston, Shnide - Anesthesiology, (40), 348 49 Ranta P, Spalding M, Kangas-Saarela T, Jokela R, Hollmen A, Jouppila P, Acta Anaesthesiol Scand, (39), 60 - 66 50 implies a high forceps rate - Journal of Obstetrics and Gynaecology, 4, 24 - 28 51 Ru epidural hematoma, infection and neurologic injury in obstetric patient Anesthesiology, 105, 394 - 399 52 epidural analgesia The journal of maternal - fetal and neonatal medicine, 24(3), 458 - 460 53 analgesia and cesarean delivery: and individual patient meta-analysis of Anesthesiology, 100, 142 - 148 54 plasma norAnesthesiolgy, (50), 524 - 55 Am J Obstet Gynecol, 131 - 59 56 Skrablin S, Grgic Comparison of intermittent and continuous epidural analgesia on delivery and progression of Journal of Obstetric and Gynaecology, 31(2), 134 -138 57 epidural analgesia in labour does delaying pushing in the second stage Journal of Obstetrics and Gynaecology, 2, 170 -172 58 Steven J.A, Jona National bureau of economic research, 149, 15 - 35 59 labour on fetal pH levels and oxidative status in uncomplicated p The journal of maternal - fetal and neonatal medicine, 15, 100 - 103 60 labour pain An International Journal of Obstetrics and Gynaecology, (116), 577 - 583 of post- Journal Psychosom Obstet Gynaecol, (29), 61 71 Thang Long University Library B NH ÁN NGHIÊN C U I.Hành Ngày vào vi Ngh nghi H a ch II.Chuyên môn Tu CTC cm GTNMC tu n PARA Th Th M Bs Sau GTNMC 30 phút CTC m h t Th M Truy n oxytocin Th i gian s thai phút Th i gian chuy n d n Ib Forceps Ch nh forceps M r ny M l y thai CTC không TT u th l Ch nh m Thai suy Apgar Cân n ng thai Tác d ng ph c a GTNMC: T t HA Bu n nơn, nơn u Bí ti u Khác M phong b v ng theo Bromage 0: C ng t hai chân, bàn chân 1: g p g i l i, hai bàn chân c ng t 2: Không g c g i, hai bàn chân cịn c ng t 3: Khơng c c hai chân ho c bàn chân