English
Русский
O'zbek
EPIDURAL ANALGEZIYANING BIRINCHI TUG'UVCHI AYOLLARDA PERINEAL TRAVMA XAVFIGA TA'SIRI VA PROFILAKTIKA CHORALARINING SAMARADORLIGI
Общая информация о статье
Homiladorlik davrida pelvik pol mushaklari mashqlari (Pelvic Floor Muscle Training — PFMT) birinchi tug‘uvchi (primipar) ayollarda perineal travma xavfini kamaytirish bo‘yicha ko‘plab ilmiy tadqiqotlarda ko‘rib chiqilgan. Ushbu sistematik sharh va meta-tahlil homiladorlikdan oldingi (antenatal) PFMT, perineal massaj va boshqa profilaktika choralari epiziotomiya, perineal yirtiqlar (birinchidan to‘rtinchi darajagacha), tug‘ruq muddati, tug‘ruqdan keyingi og‘riq, siydik va najas tuta olmaslik kabi asoratlarni oldini olishdagi samaradorligini baholaydi. Tadqiqot PubMed, Embase, Cochrane Library, Web of Science, Scopus, CINAHL va PEDro kabi ma’lumotlar bazalaridan 2010–2025-yillardagi 50 dan ortiq randomizatsiyalangan nazoratli tadqiqotlarni (Randomised Controlled Trials — RCT) o‘z ichiga oladi; umumiy ishtirokchilar soni 10 000 dan oshadi. Qidiruv strategiyasi Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) ko‘rsatmalariga muvofiq bo‘lib, kiritish mezonlari primipara ayollar, bitta hom ilali homiladorlik va antenatal interventsiyalarga asoslangan. Meta-tahlil natijalari shuni ko‘rsatadiki, 32–35-haftadan boshlab kunlik PFMT (Kegel mashqlari, ko‘prik pozitsiyasi, to‘rtoyoq pozitsiyasi va perineal massaj) epiziotomiya stavkalarini 30 50% ga (Relative Risk — RR = 0.53, 95% Confidence Interval — CI [0.42, 0.67], P < 0.001), ikkinchi darajali yirtiqlarni 40–60% ga (RR = 0.56, 95% CI [0.48, 0.65], P < 0.001) va uchinchi/to‘rtinchi darajali yirtiqlarni 45–55% ga (RR = 0.50, 95% CI [0.35, 0.71], P < 0.001) kamaytirishi mumkin. Ushbu mashqlar tug‘ruqning ikkinchi bosqichini qisqartirib (Mean Difference — MD = -15.2 min, 95% CI [-20.1, -10.3], P < 0.001), tug‘ruqdan keyingi qon yo‘qotishni pasaytirib (MD = -59.46 ml, 95% CI [-80.79, -38.12], P < 0.001) va tug‘ruqdan keyingi (postpartum) inkontinensiyani ka maytiradi (siydik tuta olmaslik RR = 0.72, 95% CI [0.59, 0.87], P < 0.0005). Subguruh tahlillari shuni ko‘rsatadiki, perineal massaj bilan birgalikda qo‘llanilganda samaradorlik oshadi, ayniqsa rivojla nayotgan mamlakatlarda. Mavzuning dolzarbligi shundaki, perineal travma butun dunyo bo‘ylab ayollar salomatligiga jiddiy tahdid soladi. Jahon sog‘liqni saqlash tashkiloti (World Health Organization — WHO) ma’lu motlariga ko‘ra, epiziotomiya stavkalari rivojlanayotgan mamlakatlarda 80% gacha yetadi. Ushbu interventsiyalar arzon va xavfsiz bo‘lib, antenatal parvarishda standartlashtirilishi mumkin. Maqola cheklovlarni (heterogenlik, kichik namuna hajmi) muhokama qilib, kelajak tadqiqotlar uchun tavsiyalar beradi, shu jumladan uzoq muddatlik kuzatuv va mobil ilovalar orqali mashqlarni davom ettirish imkoniyatlarini taklif etadi. Ushbu natijalar klinik amaliyotni yaxshilashga, tug‘ruq xarajatlarini kamaytirishga va ayollarning tug‘ruqdan keyingi hayot sifatini oshirishga yordam be radi.
1. Anwar, N., Wei, X., Jie, Y., Hongbo, Z., Jin, H., & Zhu, Z. (2024). Current advances in the treatment of myofascial pain syndrome with trigger point injections: A review. Medi cine, 103(40), e39885. https://doi.org/10.1097/MD.0000000000039885
2. Cerezo-Téllez, E., Torres-Lacomba, M., Mayoral-Del-Moral, O., Sánchez-Sánchez, B., Dom merholt, J., & Gutiérrez-Ortega, C. (2016). Prevalence of myofascial pain syndrome in chronic non-specific neck pain: A population-based cross-sectional descriptive study. PainMedicine, 17(12), 2369-2377. https://doi.org/10.1093/pm/pnw114
3. Wang T, Gu Y, Li Y, Chen J, Zeng L. Different Acupuncture Treatments for Myofascial Pain Syndrome in Neck or Shoulder: A Network Meta-Analysis Based on Randomized Controlled Trials. J Pain Res. 2025;18:4289-4305 https://doi.org/10.2147/JPR.S543756
4. Du, J., Wu, L., Pu, Y., Chen, J., & Yang, L. (2024). Effects of perineal massage at different stages on perineal and postpartum pelvic floor function in primiparous women: A systematic review and meta-analysis. BMC PregnancyandChildbirth, 24(1), 396. https://doi.org/10.1186/s12884-024-06586-w
5. Fernández-de-las-Peñas, C., &Dommerholt, J. (2024). Cervical myofascial pain treatment & management. Medscape. https://emedicine.medscape.com/article/305937-treatment
6. Kietrys, D. M., Palombaro, K. M., Azzaretto, E., Hubler, R., Schaller, B., Schlussel, J. M., & Tucker, M. (2013). Effectiveness of dry needling for upper-quarter myofascial pain: a sys tematic review and meta-analysis. The Journal of orthopaedic and sports physical ther apy, 43(9), 620–634. https://doi.org/10.2519/jospt.2013.4668
7. Leon-Larios, F., Corrales-Gutierrez, I., Casado-Mejía, R., & Suarez-Serrano, C. (2017). In fluence of a pelvic floor training programme to prevent perineal trauma: A quasi-randomised controlled trial. Midwifery, 50, 72-77. https://doi.org/10.1016/j.midw.2017.03.015
8. Liu, Q., Zhang, H., & Wang, L. (2025). Effect of image-guided myofascial release therapy on rehabilitation of neck myofascial pain syndrome. International Journal of Applied and Advanced Scientific Research, 12(5), 123-134. https://www.science gate.com/IJAAS/2025/V12I5/1021833ijaas202505020.html
, S. . (2026). EPIDURAL ANALGEZIYANING BIRINCHI TUG'UVCHI AYOLLARDA PERINEAL TRAVMA XAVFIGA TA'SIRI VA PROFILAKTIKA CHORALARINING SAMARADORLIGI. ALFRAGANUS, 6(4), –. https://doi.org/
, Saidova Z.Sh. . “EPIDURAL ANALGEZIYANING BIRINCHI TUG'UVCHI AYOLLARDA PERINEAL TRAVMA XAVFIGA TA'SIRI VA PROFILAKTIKA CHORALARINING SAMARADORLIGI.” Academic Research in Educational Sciences, vol. 4, no. 6, 2026, pp. –, https://doi.org/.
, . 2026. EPIDURAL ANALGEZIYANING BIRINCHI TUG'UVCHI AYOLLARDA PERINEAL TRAVMA XAVFIGA TA'SIRI VA PROFILAKTIKA CHORALARINING SAMARADORLIGI. Academic Research in Educational Sciences. 4(6), pp.–.