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Abstract：
OBJECTIVE: To make clinical practice guidelines for intrapartum care for healthy women and non-pharmacologic approaches for pain management.
METHODS: Review of the literature of articles published between January 2000 and September 2017 in English and French language from the Medline database, the Cochrane Library and recommendations from international institutes.
RESULTS: During the initial examination of a pregnant woman, it is recommended to take note of the pregnancy monitoring file and its possible birth plan; perform an anamnesis, inquire about her wishes and physiological and emotional needs; and perform a clinical examination (Consensus agreement). If the woman seems to be in labor, it is recommended to offer a vaginal examination (Consensus agreement). In case of premature rupture of membranes, it is recommended not to systematically perform a vaginal examination if the woman has no painful contractions (Consensus agreement). During the first stage of labor, the surveillance of the woman includes at least: a surveillance of the haemodynamic parameters every four hours; an evaluation of the frequency of uterine contractions every 30minutes and for 10minutes during the active phase; surveillance of spontaneous urination; the proposition of a vaginal examination every two to four hours or before if the patient asks for it, or in case of sign of call (Consensus agreement). During the second stage, it is recommended to use a partograph; to monitor hemodynamic parameters every hour; to evaluate the frequency of uterine contractions every 30minutes and for ten minutes; to monitor and note spontaneous urination; to offer a vaginal examination every hour (Consensus agreement). Whether on admission or during labor, it is recommended to evaluate the pain and offer the patient different ways to relieve it (Consensus agreement). It is recommended that all women have continuous, individual and personalized support, during labor and delivery (grade A); to implement the necessary human and material resources allowing women to change position regularly (Consensus agreement).
CONCLUSIONS: Routine practices must be abandoned to implement those that are scientifically justified. The management of pain is essential. Every woman should have continuous, individual and personalized support during labor and delivery.
METHODS: Review of the literature of articles published between January 2000 and September 2017 in English and French language from the Medline database, the Cochrane Library and recommendations from international institutes.
RESULTS: During the initial examination of a pregnant woman, it is recommended to take note of the pregnancy monitoring file and its possible birth plan; perform an anamnesis, inquire about her wishes and physiological and emotional needs; and perform a clinical examination (Consensus agreement). If the woman seems to be in labor, it is recommended to offer a vaginal examination (Consensus agreement). In case of premature rupture of membranes, it is recommended not to systematically perform a vaginal examination if the woman has no painful contractions (Consensus agreement). During the first stage of labor, the surveillance of the woman includes at least: a surveillance of the haemodynamic parameters every four hours; an evaluation of the frequency of uterine contractions every 30minutes and for 10minutes during the active phase; surveillance of spontaneous urination; the proposition of a vaginal examination every two to four hours or before if the patient asks for it, or in case of sign of call (Consensus agreement). During the second stage, it is recommended to use a partograph; to monitor hemodynamic parameters every hour; to evaluate the frequency of uterine contractions every 30minutes and for ten minutes; to monitor and note spontaneous urination; to offer a vaginal examination every hour (Consensus agreement). Whether on admission or during labor, it is recommended to evaluate the pain and offer the patient different ways to relieve it (Consensus agreement). It is recommended that all women have continuous, individual and personalized support, during labor and delivery (grade A); to implement the necessary human and material resources allowing women to change position regularly (Consensus agreement).
CONCLUSIONS: Routine practices must be abandoned to implement those that are scientifically justified. The management of pain is essential. Every woman should have continuous, individual and personalized support during labor and delivery.
摘要：
目的：为健康妇女的产时护理和疼痛管理的非药物方法制定临床实践指南。
方法：对Medline数据库中2000年1月至2017年9月以英语和法语发表的文章的文献进行回顾，Cochrane图书馆和国际机构的建议。
结果：在孕妇的初次检查中，建议注意怀孕监测文件及其可能的生育计划;进行回忆，询问她的愿望以及生理和情感需求；并进行临床检查（共识协议）。如果那个女人似乎在分娩，建议提供阴道检查（共识协议）。如果胎膜早破，如果女性没有疼痛的宫缩，建议不要系统地进行阴道检查（共识）。在劳动的第一阶段，对妇女的监测至少包括：每4小时监测一次血流动力学参数；在活动期每30分钟和10分钟评估一次子宫收缩的频率；监测自发排尿；如果患者要求，则建议每2至4小时进行一次阴道检查，或在签署电话(共识协议)的情况下。在第二阶段,建议使用产图仪;每小时监测一次血流动力学参数;每30分钟和10分钟评估一次子宫收缩的频率;监测并记录自发排尿;每小时提供一次阴道检查(共识协议)。无论是入院时还是分娩期间，建议评估疼痛，并为患者提供不同的缓解方法（共识协议）。建议所有女性都有连续的，个人和个性化的支持，在劳动和分娩期间（A级）；实施必要的人力和物力资源，使妇女能够定期更换职位（共识协议）。
结论：必须放弃常规做法，以实施科学上合理的做法。疼痛的管理至关重要。每个女人都应该有连续的，在劳动和分娩期间提供个人和个性化的支持。
方法：对Medline数据库中2000年1月至2017年9月以英语和法语发表的文章的文献进行回顾，Cochrane图书馆和国际机构的建议。
结果：在孕妇的初次检查中，建议注意怀孕监测文件及其可能的生育计划;进行回忆，询问她的愿望以及生理和情感需求；并进行临床检查（共识协议）。如果那个女人似乎在分娩，建议提供阴道检查（共识协议）。如果胎膜早破，如果女性没有疼痛的宫缩，建议不要系统地进行阴道检查（共识）。在劳动的第一阶段，对妇女的监测至少包括：每4小时监测一次血流动力学参数；在活动期每30分钟和10分钟评估一次子宫收缩的频率；监测自发排尿；如果患者要求，则建议每2至4小时进行一次阴道检查，或在签署电话(共识协议)的情况下。在第二阶段,建议使用产图仪;每小时监测一次血流动力学参数;每30分钟和10分钟评估一次子宫收缩的频率;监测并记录自发排尿;每小时提供一次阴道检查(共识协议)。无论是入院时还是分娩期间，建议评估疼痛，并为患者提供不同的缓解方法（共识协议）。建议所有女性都有连续的，个人和个性化的支持，在劳动和分娩期间（A级）；实施必要的人力和物力资源，使妇女能够定期更换职位（共识协议）。
结论：必须放弃常规做法，以实施科学上合理的做法。疼痛的管理至关重要。每个女人都应该有连续的，在劳动和分娩期间提供个人和个性化的支持。
