早在2002年美国妇产科医师学会(American College of Obstetricians and Gynecologists,ACOG)就提出:在没有医学禁忌的情况下,孕妇要求减轻分娩疼痛即为分娩镇痛足够的医学指征。在2019年的更新中,ACOG重申了这一观点,并特别指出:所有接产医院应提供分娩镇痛服务,且不因孕妇的支付能力而受到限制。
中华医学会麻醉学分会(Chinese Society of Anesthesiology,CSA)《分娩镇痛专家共识(2016版)》及《中国分娩镇痛专家共识(2020版)》指出,分娩镇痛的适应证包括:①孕妇自愿;②经产科医师评估,可进行阴道分娩试产者(包括瘢痕子宫、妊娠期高血压及子痫前期等)。
因此,只要孕妇临产(即有规律的宫缩造成宫颈扩张和消失)和有要求就可以做分娩镇痛。
[1]GOETZL L M,ACOG Committee on Practice Bulletins-Obstetrics. ACOG Practice bulletin. clinical management guidelines for obstetrician-gynecologists number 36,July 2002. Obstetric analgesia and anesthesia [J]. Obstet Gynecol,2002,100(1):177-191.
[2]American College of Obstetricians and Gynecologists' Committee on Practice Bulletins-Obstetrics. ACOG practice bulletin No.209:Obstetric analgesia and anesthesia [J]. Obstet Gynecol,2019,133(3):e208-e225.
[3]中华医学会麻醉学分会产科学组.分娩镇痛专家共识(2016版)[J].临床麻醉学杂志,2016,32(8):816-818.
[4]CHESTNUT D H. Chestnut's obstetric anesthesia:Principles and practice [M]. 6th ed. Philadelphia:Elsevier,2020:476.