Objective To investigate the causes and remedial measures of the failure of continuous epidural for labor analgesia. Methods Nine hundred and fifty-two primiparas who received voluntary labor analgesia were selected. They received epidural block in the L2-3 interspace, and epidural catheter was inserted 4 cm into the epidural space. The method of labor analgesia was continuous intravenous injection combined with self controlled analgesia. The visual analogue score (VAS) >5 scores was analgesia failure. Withdrawing the epidural catheter 1 to 2 cm and replacement of the catheter or changing to subarachnoid space combined with epidural block was used to rescue the analgesia failure. The production process progress and satisfaction rate of postpartum 24 h were recorded. Results The analgesia failure was in 144 cases, and the analgesia failure rate was 15.1%(144/952), among which the epidural catheter was inserted into blood vessels in 47 cases, the epidural catheter was blocked by a blood clot in 13 cases, the epidural catheter bent in 9 cases, the unilateral block or partial block was in 31 cases, the epidural catheter migrated in 37 cases, the catheters left the epidural cavity in 5 cases, and dural puncture was in 2 cases. Eighty-seven cases were treated by withdrawing the epidural catheter 1 to 2 cm, 48 cases were treated by replacement of the catheter, and 9 cases were treated by changing to subarachnoid space combined with epidural block. The satisfaction rate of postpartum 24 h was 96.7%(921/952). Conclusions The failure of continuous epidural block for labor analgesia is higher. According to the different causes, the most of the failures could be rescued by withdrawing the epidural catheter 1 to 2 cm, replacement of the catheter or changing to subarachnoid space combined with epidural block.

Objective: To learn the status and influencing factors of development among infants at ages of 0 to 36 months in Xiaoshan District, Hangzhou City, so as to provide the reference for promoting healthy development of infants. Methods: Infants at ages of 0-36 months who underwent physical examination in Child Health Clinic of Xiaoshan District Community Health Service Center were selected in 2022. General data of infants and their mothers were collected through questionnaires, and the development status of infants was screened by Age and Stages Questionnaire (third edition). Factors affecting the development status were identified using a multivariable logistic regression model. Results: A total of 2 519 infants were investigated, including 1 339 males (53.16%) and 1 180 females (46.84%). There were 608 infants with abnormal development of at least one functional area of communication (CM), gross motor (GM), fine motor (FM), problems solving (CG) and personal-social (PS). The abnormal rate was 24.14%, and the abnormal rates of the above functional areas were 9.77%, 6.59%, 7.98%, 6.39% and 9.33%, respectively. Multivariable logistic regression analysis showed that gender (male, OR=1.563, 95%CI: 1.191-2.052), mother's childbearing age (≥35 years, OR=1.411, 95%CI: 1.001-1.988), mother's educational level (lower than junior college, OR=1.460, 95%CI: 1.116-1.912) were factors affecting abnormal development of CM; preterm birth (OR=2.323, 95%CI: 1.315-4.103) was factors affecting abnormal development of GM; gender (male, OR=1.654, 95%CI: 1.225-2.232) was factors affecting abnormal development of FM; gender (male, OR=1.511, 95%CI: 1.086-2.102) and mode of delivery (cesarean section, OR=1.460, 95%CI: 1.060-2.010) were factors affecting abnormal development of CG; gender (male, OR=1.340, 95%CI: 1.019-1.763) and birth weight (low birth weight, OR=1.985, 95%CI: 1.149-3.432) were factors affecting abnormal development of PS. Conclusions The rate of abnormal development among infants at ages of 0 to 36 months in Xiaoshan District is 24.14%. Gender, preterm birth, mode of delivery, birth weight, mother's childbearing age and mother's educational level could affect the development status of infants.