| Summary: | 碩士 === 國立臺北護理健康大學 === 護理助產研究所 === 105 === Background: Induction/augmentation of labor is currently common obstetric interventions in Taiwan. However, literatures have indicated that the timing of intervention and the maturation of the mother's cervix can impact the risk of mothers who underwent cesarean delivery after the induction/ augmentation of labor. These interventions can also impact mother postpartum recovery as well as breastfeeding.
Purpose: To determine the correlations among women belonging to different Bishop subgroups and their delivery methods, delivery time, and levels of fatigue.
Methods: The participants were conveniently sampled from a maternity ward in a medical institution in northern Taiwan. The participants consisted of women aged 18 and over, between 37-42 weeks of pregnancy, without high-risk pregnancy, without mental illness, and without epidural anesthesia for vaginal delivery. The participants were separated into 3 groups according to their Bishop Scores: less than 4 points (Group 1); 4 to 6 points (Group 2); and greater than 6 points (Group 3). A total of 230 valid subjects were enrolled. The data were collected by questionnaires such as basic demographic data, Bishop Score, and fatigue scale. The questionnaires were completed at admission as well as 8 hours after delivery.
Results: Group 1 had higher numbers of weeks of gestation than the other two groups (F = 4.00, p = .020). Group 1 also had a higher rate of labor induction than the other two groups. Group 3 had the higher rate of labor augmentation than the other two groups (c2=34.03, p< .001). Women who were undergoing first deliveries with induction/augmentation of labor exhibited lower Bishop scores than those who gave birth more than once (c2=13.12, p< .001). Group 1 had a higher rate of cesarean section than the other two groups (c2=11.21, p< .001); increased duration of admission to medication intervention time (F=5.74, p=.004); duration of admission to regular uterine contraction (F=8.28, p<.001); duration of admission to fully cervix dilation (F=22.00, p<.001); and successfully vaginal delivery (F=23.76, p<.001). Participants in the three groups showed no statistical difference in their demographic data (education level, age, newborn Apgar scores, newborn weight, and newborn head circumference) and fatigue levels (p>.05).
Conclusions and Clinical Applications: For women with greater than 39 weeks of gestation receiving labor induction/augmentation, the higher the women's Bishop score the higher the probability of successful vaginal delivery. These women are also with shorten the time of labor. Women with lower Bishop scores are associated with higher rate of cesarean section. The result from this study suggested that for women with more than 39 weeks of gestation, induction/augmentation of labor should be performed with those with Bishop scores of greater than 4 points to improve the success rate of vaginal delivery, reduce the rate of cesarean section and delivery duration. Hospitalization is suggested for women with 41 weeks of gestation with no signs of delivery. A Bishop score of more than 4 should be achieved before labor interventions. In addition, perinatal health providers should be educated in cervical maturation assessment in addition to the regular maternal and infant care trainings to promote better birth outcomes.
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