胎児, 出生児からみた無痛分娩 Effects of Epidural Labor Analgesia on the Fetus and Newborn

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著者

    • 林 玲子 HAYASHI Reiko
    • 国立成育医療研究センター手術・集中治療部 Department of Critical Care and Anesthesia, National Center for Child Health and Development

抄録

  分娩の痛みは個人差があるが,陣痛の刺激により母体の血圧上昇,過呼吸を生じるような場合は二次的に臍帯血管の収縮,子宮胎盤血流低下をきたし,さらには間接的に胎児への酸素供給低下などの影響を起こしうることがわかっている.よって硬膜外麻酔による無痛分娩は,母体の痛みを取り除くだけではなく胎児に起こりうる二次的な悪影響を防ぐことが可能である.母体への硬膜外麻酔が与える胎児・新生児への影響は直接的,間接的なものが考えられるが,臍帯血流の維持を念頭に硬膜外麻酔による合併症の早期発見がなされるような麻酔管理が行われていれば,麻酔の利点を最大限に胎児・新生児に還元することが可能である.

  Labor is painful and the majority of women rate the pain as severe. Melzack observed that labor pain was rated as more painful than cancer pain.<br>  Labor pain itself has no direct effect on the fetus, because there is no direct neural connection from the mother to the fetus. However, labor pain can influence multiple factors that, in turn, may influence maternal hypertension, hyperventilation and uteroplacental perfusion. Uterine artery vasoconstriction, caused by maternal catecholamine release, may decrease oxygen supply to the fetus.<br>  These effects are well tolerated in normal circumstances and are effectively blocked by epidural analgesia. Epidural analgesia may be especially important to fetal well-being when these effects of labor pain impinge on situations of limited uteroplacental reserve.<br>  Although the epidural analgesia does have some side effects and complications, it can provide beneficial effects for the fetus and newborn as long as the side effects and complications of epidural analgesia are prevented or effectively treated.

収録刊行物

  • 日本臨床麻酔学会誌 = The Journal of Japan Society for Clinical Anesthesia

    日本臨床麻酔学会誌 = The Journal of Japan Society for Clinical Anesthesia 32(3), 331-336, 2012-05-15

    THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA

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各種コード

  • NII論文ID(NAID)
    10030763133
  • NII書誌ID(NCID)
    AN00330159
  • 本文言語コード
    JPN
  • 資料種別
    REV
  • ISSN
    02854945
  • データ提供元
    CJP書誌  J-STAGE 
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