Use of Cesarean Birth among Robson Groups 2 and 4 at Mizan-Tepi University Hospital, Ethiopia.

IF 1.6 Q3 OBSTETRICS & GYNECOLOGY
Obstetrics and Gynecology International Pub Date : 2020-09-04 eCollection Date: 2020-01-01 DOI:10.1155/2020/5620987
Margo S Harrison, Tewodros Liyew, Ephrem Kirub, Biruk Teshome, Andrea Jimenez-Zambrano, Margaret Muldrow, Teklemariam Yarinbab
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引用次数: 0

Abstract

Background: Primary cesarean birth rates were high among women who were either nulliparous (Group 2) or multiparous (Group 4) with a single, cephalic, term fetus who were induced, augmented, or underwent cesarean birth before labor in our study cohort.

Objectives: The objective of this analysis was to determine what risk factors were associated with cesarean birth among Robson Groups 2 and 4.

Methods: This study was a prospective hospital-based cross-sectional analysis of a convenience sample of 1,000 women who delivered at Mizan-Tepi University Teaching Hospital in the summer and fall of 2019.

Results: Women in Robson Groups 2 and 4 comprised 11.4% (n = 113) of the total population (n = 993). The cesarean birth rate in Robson Group 2 (n = 56) was 37.5% and in Robson Group 4 (n = 57) was 24.6%. In Robson Group 2, of all prelabor cesareans (n = 5), one birth was elective cesarean by maternal request; the intrapartum cesarean births (n = 16) mostly had a maternal or fetal indication (93.8%), with one birth (6.2%) indicated by "failed induction or augmentation," which was a combined indication. In Robson Group 4, all 4 women delivered by prelabor cesarean had a maternal indication (one was missing data), and 3 of the intrapartum cesareans were indicated by "failed induction or augmentation." In multivariable modeling of Robson Group 2, having a labor duration of "not applicable" increased the risk of cesarean delivery (RR 2.9, CI (1.5, 5.4)). The odds of requiring maternal antibiotics was the only notable outcome with increased risk (RR 11.1, CI (1.9, 64.9)). In multivariable modeling of Robson Group 4, having a labor longer than 24 hours trended towards a significant association with cesarean (RR 3.6, CI (0.9, 14.3)), and women had a more dilated cervix on admission trended toward having a lower odds of cesarean (RR 0.8, CI (0.6, 1.0)).

Conclusion: Though rates of primary cesarean birth among women who have a term, single, cephalic fetus and are induced, augmented, or undergone prelabor cesarean birth are high, those that occur intrapartum seem to be associated with appropriate risk factors and indications, though we cannot say this definitely as we did not perform an audit. More research is needed on the prelabor subgroup as a separate entity.

Abstract Image

埃塞俄比亚米赞-特皮大学医院罗布森第2组和第4组剖宫产的使用
背景:在我们的研究队列中,无产(第2组)或多产(第4组)单胎、头足月胎儿引产、增产或产前剖宫产的妇女中,原发性剖宫产率很高。目的:本分析的目的是确定Robson 2组和4组中与剖宫产相关的危险因素。方法:本研究是对2019年夏季和秋季在米赞特皮大学教学医院分娩的1000名妇女的便利样本进行前瞻性医院横断面分析。结果:Robson组2和4的女性占总人数(n = 993)的11.4% (n = 113)。Robson 2组(n = 56)剖宫产率为37.5%,Robson 4组(n = 57)剖宫产率为24.6%。在Robson组2中,所有产前剖宫产(n = 5)中,1例分娩应产妇要求选择剖宫产;产时剖宫产(n = 16)多数有母体或胎儿指征(93.8%),1例(6.2%)为“诱导或增强失败”,为综合指征。在Robson组4中,所有4名分娩前剖宫产的妇女都有产妇指征(1名缺少数据),其中3名分娩时剖宫产的指征是“诱导或增强失败”。在Robson组2的多变量建模中,分娩时间“不适用”增加了剖宫产的风险(RR 2.9, CI(1.5, 5.4))。需要母体抗生素的几率是风险增加的唯一显著结局(RR 11.1, CI(1.9, 64.9))。在Robson Group 4的多变量模型中,分娩时间超过24小时与剖宫产有显著相关性(RR 3.6, CI(0.9, 14.3)),入院时宫颈扩张程度较高的妇女剖宫产的几率较低(RR 0.8, CI(0.6, 1.0))。结论:虽然足月、单胎、头位胎儿以及引产、增产或产前剖宫产的妇女的原发性剖宫产率很高,但产时发生的剖宫产似乎与适当的危险因素和适应症有关,尽管我们不能肯定地说这一点,因为我们没有进行审计。需要对产前亚组作为一个单独的实体进行更多的研究。
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来源期刊
Obstetrics and Gynecology International
Obstetrics and Gynecology International OBSTETRICS & GYNECOLOGY-
CiteScore
3.60
自引率
0.00%
发文量
26
审稿时长
19 weeks
期刊介绍: Obstetrics and Gynecology International is a peer-reviewed, Open Access journal that aims to provide a forum for scientists and clinical professionals working in obstetrics and gynecology. The journal publishes original research articles, review articles, and clinical studies related to obstetrics, maternal-fetal medicine, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine and infertility, reproductive endocrinology, and sexual medicine.
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