足月妊娠妇女紧急剖宫产的引产和风险

Gomathy Ethiraj, Aditi C. Ramachandra, Sandhya Rajan
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引用次数: 2

摘要

背景:引产已经成为产科最常见的干预措施之一,正因为如此,我们有越来越多的剖腹产。识别这些增加剖宫产风险的风险因素变得很重要,这样我们就可以诱导患者降低剖宫产的风险。剖宫产应使用产科概念和引产参数进行审核。方法:对妊娠37~42周的孕妇进行前瞻性病例对照研究,这些孕妇从产房招募,为期1年。所有参与该研究的女性都接受了临床检查,以评估Bishop评分、产科扫描和心脏分娩图(CTG)。诱导使用米索前列醇50µg,每6小时一次,24小时内最多四次,如果需要,还可以添加催产素。在我们位于卡纳塔克邦科拉尔区的三级医院,我们决定对178名患者进行抽样研究。我们评估了足月妊娠的风险因素及其引产后的分娩结果。考虑了基线人口统计细节以及妊娠风险因素。还考虑了引产剂以及剖宫产患者的引产间隔。妊娠结局已确定。结果:本研究得出结论,与先兆子痫、妊娠期高血压、过期妊娠和妊娠期糖尿病等其他风险因素相比,剖宫产的重要风险因素是羊水过少引起的初产妇胎儿窘迫。入职前主教评分<6。在这些妇女中,有43名因胎儿窘迫而在引产后接受了剖腹产,以进行不可靠的无压力试验(NST)。初产妇在引产后剖宫产的风险为4.4倍,在研究中,没有羊水过少是一个保护因素,比值比为0.2。结论:在我们的研究中,足月引产减少了剖宫产的次数,这是一个单一的风险因素。《临床妇科产科杂志》。2019年;8(1):17-20 doi:https://doi.org/10.14740/jcgo433w
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Induction of Labor and Risk for Emergency Cesarean Section in Women at Term Pregnancy
Background: Induction of labor has become one of the most common interventions in obstetrics, and because of this we have the increasing number of Cesarean sections. Identifying these risk factors which increase the risk of Cesarean section has become important so that we can induce patients putting them in lower risk of Cesarean section. Cesarean sections should be audited using the obstetrical concepts and parameters for induction of labor. Methods: A prospective case-control study has been conducted among pregnant women between 37 - 42 weeks of gestation, who were recruited from the labor ward for a period of 1 year. All women enrolled for the study were clinically examined to assess for Bishop’s score, obstetric scan and cardiotocography (CTG). Induction was done using tab misoprostol 50 µg 6th hourly for a maximum of four doses in 24 h and augmented with oxytocin if required. In our tertiary hospital in Kolar district of Karnataka we decided to conduct a study with a sample size of 178 patients. We assessed the risk factors in term pregnancies and their delivery outcome following induction. Baseline demographic details along with pregnancy risk factors were taken into account. Induction agent as well as induction to delivery interval with those that underwent Cesarean section was also taken into account. Pregnancy outcome was determined. Results: This study concluded that significant risk factor for Cesarean was primigravida with fetal distress due to oligohydramnios, compared to other risk factors such as preeclampsia, gestational hypertension, post-dated pregnancy and gestational diabetes mellitus. Bishops score prior to induction was < 6. Out of these women 43 underwent Cesarean after induction in view of fetal distress for non reassuring nonstress test (NST). Primigravida had a risk of 4.4 times for Cesarean after induction, and absence of oligohydramnios was a protective factor in the study with odds ratio of 0.2. Conclusions: Induction of labor at term has reduced the number of Cesarean sections in our study with a single risk factor. J Clin Gynecol Obstet. 2019;8(1):17-20 doi: https://doi.org/10.14740/jcgo433w
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