[足月孕妇剖宫产风险评估]。

Carlos José Molina-Pérez, María Guadalupe Berumen-Lechuga, Alfredo Leaños-Miranda
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引用次数: 0

摘要

背景:每年约有1.4亿例分娩,其中大多数是无危险因素妇女的自然分娩,导致阴道分娩健康新生儿。目的:建立一种预后评分方法来预测住院时首次分娩时单胎活产的足月孕妇剖宫产的概率。材料和方法:通过病例对照研究,纳入住院时初产的足月孕妇。病例是在紧急剖宫产中分娩的妇女,对照组是正常阴道分娩的妇女。询问临床病史,并进行完整的体格检查。计算比值比(OR)和95%置信区间。结果:共纳入70例女性,其中27例为病例,43例为对照组。各组产妇体重、肥胖、初产、子宫活动、胎膜早破史、宫颈扩张、宫颈糜烂等指标差异均有统计学意义(p < 0.05)。与剖宫产风险相关的因素为产妇肥胖、初产、胎膜早破、子宫扩张< 6 cm、子宫内膜脱落< 50% (OR≥3.3)。评分≥3.5分与剖宫产风险相关,敏感性为81.5%,特异性为79%。结论:与剖宫产风险相关的因素是产妇肥胖、初产和胎膜早破。在建议的量表上得分b> - 4分与剖宫产的风险相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Cesarean section risk assessment for pregnant women at term].

Background: Every year, approximately 140 million births occur, with the majority being spontaneous deliveries in women without risk factors, resulting in vaginal births of healthy newborns.

Objective: To develop a prognostic score to predict the probability of cesarean section in pregnant women at term with a single live fetus presenting with initial labor at hospital admission.

Material and methods: Through a case-control study, pregnant women at term with initial labor at hospital admission were included. Cases were women with labor that culminated in an emergency cesarean section and controls were women who had a normal vaginal delivery. Clinical history was questioned, and a complete physical examination was performed. The odds ratio (OR) and 95% confidence intervals were calculated.

Results: Seventy women were included, 27 cases and 43 controls. There were differences between groups in maternal weight, obesity, primiparity, uterine activity, history of premature rupture of membranes (PROM), cervical dilatation and effacement (p < 0.05). Factors associated with the risk of cesarean delivery were maternal obesity, primiparity, PROM, dilatation < 6 cm, and effacement < 50% (OR ≥ 3.3). Score ≥ 3.5 on the proposed scale is associated with the risk of cesarean delivery with a sensitivity of 81.5% and a specificity of 79%.

Conclusion: Factors associated with the risk of cesarean delivery are maternal obesity, primiparity, and PROM. Score >4 points on the proposed scale is associated with the risk of cesarean delivery.

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