| Objective:To explore the effect of PCEA combined with delivery ball on serum prostaglandin E2（PGE2）of pregnant women with Gestational Diabetes Mellitus（GDM）,delivery analgesia effect and mother and infant.Methods:200pregnant women who planned to have full term vaginal delivery to terminate pregnancy in our hospital from July 2020 to June 2022 were collected.They were divided into A:GDM analgesic group,B:GDM control group,C:normal analgesic group and D:normal control group,with 50 cases in each group.The effectiveness of analgesia（VAS score）,duration of labour,serum prostaglandin E2values,mode of delivery（normal and caesarean）,postpartum vaginal bleeding,perinatal outcome（neonatal blood glucose,umbilical artery blood gas,Apgar score）and postpartum follow-up were observed and recorded.Statistical analysis was performed to compare the analgesic effect of PCEA combined with delivery ball,the safety and effectiveness of the PCEA on mother and baby,and the effect of serum prostaglandin E2.Results:1.General data:There was no statistically significant difference between the four groups in terms of maternal age,pre-pregnancy body mass index and gestational weeks（P>0.05）,and no significant difference in neonatal birth weight（P>0.05）.2.Analgesic effect:VAS scores of latent phase（pre-analgesia）were compared between the four groups and there was no difference（P>0.05）.During the active period（VAS score）between groups,the analgesic component values were significantly lower than those of the control group（P<0.05）.Moreover,there was no statistically significant difference between the GDM analgesic group and the normal analgesic component values（P>0.05）.Before and after the group（VAS score）,the active phase in the pain group had a significantly lower score than the latent phase（pre-analgesia）（P<0.05）.3.Maternal outcome:（1）Compared with the first and second stages of labor among the four groups,the duration of the analgesia group was significantly longer than that of the control group（P<0.05）,but it was not related to GDM（P>0.05）.It can be shown from the Comparisons between two groups that analgesia had little effect on the third stage of labor in GDM group（P>0.05）.Yet analgesia had significant effect on the normal group（P<0.05）.（2）Comparing the PGE2values of the first stage of labour between the four groups,the analgesic group was significantly lower than the control group（P<0.05）,independent of whether it was GDM or not（P>0.05）.There was no significant difference in PGE2levels in the second stage of labour between the groups（P<0.05）.There was also no statistically significant difference in the rate of caesarean section,vaginal assisted delivery and postpartum vaginal bleeding between the four groups（P>0.05）.4.Neonatal outcome:（1）The neonatal blood glucose in the GDM control group was significantly lower than that in the GDM analgesia group,the normal analgesia group and the normal control group（P<0.05）.In addition,analgesia had no significant effect on neonatal blood glucose in the normal group（P>0.05）.（2）There was no significant difference between the four groups in neonatal blood gas and Apgar score（P>0.05）.5.Follow-up after delivery:There was no statistical difference in the comparison of the four groups in terms of maternal effusion and neonatal feeding（P>0.05）.Conclusions:1.PCEA combined with delivery ball analgesia has a significant effect on the delivery pain of GDM women.Although the labor time is slightly longer,it does not increase the rate of cesarean section and vaginal delivery.And it can effectively avoid the occurrence of neonatal hypoglycaemia and does not cause adverse perinatal outcomes.2.PCEA combined with ball analgesia inhibited the secretion of PGE2in the first stage of labor,but had little effect on the secretion of PGE2in the second stage of labor.3.PCEA combined with delivery ball analgesia did not affect postpartum uterine involution and breast feeding of GDM women. |
