diplomsko delo
Povzetek
Uvod: V zadnjih letih je močno priljubljena uporaba epiduralne analgezije kot način lajšanja
bolečine med porodom. Zagotavlja učinkovito lajšanje in omogoča polno sodelovanje
porodnice. Nekateri ugotavljajo, da epiduralna analgezija vpliva na potek in izid poroda. 85
% porodnic po svetu med porodom utrpi poškodbo presredka. Ta lahko povzroči velike
telesne, psihološke, spolne in socialne težave pri porodnici. Namen: Namen je ugotoviti
kakšen vpliv ima epiduralna analgezija na poškodbe presredka med porodom. Zastavili smo
si 3 raziskovalna vprašanja, kakšen vpliv ima epiduralna analgezija neposredno na spontane
poškodbe presredka, kakšen vpliv ima na epiziotomije ter kako posredno vpliva na poškodbe
presredka. Metode dela: Za raziskovanje je bila uporabljena diskriptivna metoda dela s
pregledom strokovne in znanstvene literature. Literaturo smo iskali v spletnih bazah
podatkov od decembra 2022 do februarja 2023. S pomočjo Prisma diagrama smo izbrali 8
vsebinsko ustreznih in v celoti dostopnih študij v angleškem jeziku. Rezultati: Porodnice z
epiduralno analgezijo večkrat rodijo v litotomnem položaju. Kar vpliva na pojav večjih
raztrganin presredka. Uporaba epiduralne analgezije poveča verjetnost za podaljšano I. in II.
porodno dobo in s tem za več kot 8 krat poveča verjetnost za pospeševanje poroda z
uterotoniki. Medicinski postopki za hitrejše napredovanje poroda, ki se jih uporablja ob
podaljšani II. porodni dobi, povečajo verjetnost za pojav večjih raztrganin presredka.
Epiduralna analgezija neposredno ne vpliva na spontane poškodbe presredka. Tveganje za
epiziotomijo je pri tistih z epiduralno analgezijo za 1,9 krat večje kot pri tistih brez nje.
Razprava in zaključek: Večina ugotavlja, da epiduralna analgezija neposredno ne vpliva
na spontane poškodbe presredka, med njimi večje raztrganine presredka. Poveča pa
verjetnost za epiziotomijo preko povečane verjetnosti za inštrumentalno dokončanje poroda.
Prav tako ugotavljajo, da poveča verjetnost za podaljšano II. porodno dobo, pospeševanje
poroda z uterotoniki, nepravilno vstavo vodilnega plodovega dela, rojevanje v litotomnem
položaju in inštrumentalno dokončanje poroda. Vsi ti dejavniki pa povečajo verjetnost za
spontane poškodbe presredka ter epiziotomijo. Ugotavljamo, da epiduralna analgezija
posredno vpliva na povečano verjetnost za poškodbe presredka. Pomembno je, da babice
predstavljajo podporo porodnicam, da med popadki zmorejo premagovati bolečino in se za
epiduralno analgezijo odločajo samo kadar jo zares potrebujejo.
Ključne besede
diplomska dela;babištvo;epiduralna analgezija;presredek;poškodbe;porod;
Podatki
Jezik: |
Slovenski jezik |
Leto izida: |
2023 |
Tipologija: |
2.11 - Diplomsko delo |
Organizacija: |
UL ZF - Zdravstvena fakulteta |
Založnik: |
[H. Zajc] |
UDK: |
618.2/.7 |
COBISS: |
161731843
|
Št. ogledov: |
43 |
Št. prenosov: |
13 |
Ocena: |
0 (0 glasov) |
Metapodatki: |
|
Ostali podatki
Sekundarni jezik: |
Angleški jezik |
Sekundarni naslov: |
Epidural analgesia and perineal trauma during labour: a literature review |
Sekundarni povzetek: |
Introduction: For the last few years, epidural analgesia has been a very popular method
used for reducing pain during labour. It provides effective relief of pain and enables the full
participation of women during labour. Some note that epidural analgesia affects the course
and outcome of labour. During labour, 85 % of women around the world suffer some degree
of perineal laceration. It can cause major physical, psychological, sexual and social
problems. Purpose: The aim is to determine the impact of epidural analgesia on perineal
lacerations during childbirth. We asked ourselves three research questions: what affect does
epidural analgesia have directly on spontaneous perineal lacerations, what effect does it have
on episiotomies, and how does it indirectly affect perineal lacerations. Methods: For
research a descriptive method was used with a review of professional and scientific
literature. Literature was searched in online databases from December 2022 to February
2023. Using the Prisma diagram, we found 8 relevant, content-appropriate and fully
accessible articles in English. Results: Women in labour with epidural analgesia often give
birth in the lithotomy position which increases the likelihood of severe perineal lacerations.
Use of epidural analgesia increases the probability of the prolonged I. and II. stage of labour
and stimulation of labour with uterotonics is 8 times higher among those with epidural
analgesia. Medical procedures for faster progress of labour which are used during prolonged
II. stage of labour increase the likelihood of severe perineal lacerations. Epidural analgesia
does not directly affect spontaneous perineal lacerations. The risk of episiotomy is 1.9 times
greater in those with epidural analgesia than in those without it. Discussion and conclusion:
Most researchers note that epidural analgesia does not directly affect spontaneous perineal
lacerations, including severe perineal lacerations. Epidural analgesia increases the likelihood
of episiotomy with the increased likelihood of instrumental delivery. They also note that it
increases the likelihood of prolonged II. stage of labour, stimulation of labour with
uterotonics, abnormal foetal position, birth in the lithotomy position and instrumental
delivery. All those factors increase the likelihood of spontaneous perineal lacerations,
including severe perineal lacerations, and episiotomy. We conclude that epidural analgesia
indirectly affects the increased probability of perineal injuries. It is important that midwives
provide support to the women in labour, encourage to withstand the pain during contractions
so they decide to use epidural analgesia only when most necessary. |
Sekundarne ključne besede: |
diploma theses;midwifery;epidural analgesia;perineum;lacerations;labour; |
Vrsta dela (COBISS): |
Diplomsko delo/naloga |
Študijski program: |
0 |
Konec prepovedi (OpenAIRE): |
1970-01-01 |
Komentar na gradivo: |
Univ. v Ljubljani, Zdravstvena fak., Oddelek za babištvo |
Strani: |
49 str. |
ID: |
19661063 |