卡波姆产道凝胶对足月初产妇第二产程及分娩结局的影响

Effect of carbomer-based vaginal gel on the second stage of labor and delivery outcomes in full-term primiparous women

摘要:

目的 探究应用卡波姆产道凝胶对足月初孕妇第二产程及分娩结局的影响。方法 选取2024年9月—2025年10月于西湖大学医学院附属杭州市第一人民医院住院分娩的足月单胎头位并使用椎管内镇痛分娩的240例初产妇。通过随机数字表法将患者分为观察组与对照组，各120例。观察组涂抹卡波姆产道凝胶，对照组不涂抹卡波姆产道凝胶。比较两组妊娠结局（中转剖宫产率、阴道助产率、会阴切开率及产后尿潴留率）、第二产程时长、新生儿Apgar评分、转新生儿重症监护病房（NICU）、接受椎管内镇痛时的宫口扩张程度、第一产程活跃期后阴道检查次数、第二产程阴道检查次数、并发症等情况。结果 观察组中转剖宫产率低于对照组（P <0.05）。观察组第二产程短于对照组（P <0.05）。对照组与观察组1和 5min Apgar评分、转NICU率、接受椎管内镇痛时的宫口扩张程度、第一产程活跃期后阴道检查次数及第二产程阴道检查次数比较，差异均无统计学意义（P >0.05）。观察组并发症总发生率低于对照组（P <0.05）。结论 卡波姆产道凝胶应用于椎管内镇痛下阴道分娩可缩短第二产程、降低中转剖宫产率，改善分娩结局。

Abstract:

Objective To investigate the effects of carbomer-based vaginal gel on the second stage of labor and delivery outcomes in full-term primiparous women.Methods A total of 240 primiparous women with full-term singleton cephalic pregnancies who underwent labor with neuraxial analgesia at The Affiliated Hangzhou First People's Hospital of Westlake University School of Medicine between September 2024 and October 2025 were enrolled. Participants were randomly assigned to an observation group (n = 120) and a control group (n = 120) using a random number table. Carbomer-based vaginal gel was applied in the observation group, whereas no carbomer-based vaginal gel was used in the control group. Pregnancy outcomes (the rate of intrapartum conversion to cesarean section, operative vaginal delivery rate, episiotomy rate, and postpartum urinary retention rate), the duration of the second stage of labor, neonatal Apgar scores, neonatal intensive care unit (NICU) admission, cervical dilatation at the initiation of neuraxial analgesia, the number of vaginal examinations after the onset of the active phase of the first stage of labor, the number of vaginal examinations during the second stage of labor, and complications were compared between the two groups.Results The caesarean section rate was lower in the observation group than in the control group (P < 0.05). The duration of the second stage of labor in the observation group was shorter than that in the control group (P < 0.05). There were no statistically significant differences between the control and observation groups in terms of 1-minute Apgar scores, 5-minute Apgar scores, NICU admission rates, cervical dilatation at the initiation of neuraxial analgesia, the number of vaginal examinations after the onset of the active phase of the first stage of labor, or the number of vaginal examinations during the second stage of labor (P > 0.05). The overall incidence of complications in the observation group was lower than that in the control group (P < 0.05).Conclusion The application of carbomer-based vaginal gel during vaginal delivery under neuraxial analgesia can shorten the second stage of labor, reduce the rate of intrapartum conversion to cesarean section, and improve delivery outcomes.