墨西哥城一群墨西哥妇女在水中分娩的经历

Vargas Hernández Víctor Manuel, Luján Irastorza Jesús Estuardo, D. Carlos, H. Roberto, Ávila Pérez Felipe de Jesús, Á. Daniela, K. Alejandro, Guerrero Vargas José Juan, Valdez-Chávez Teresita de Jesús, Silva-Meléndez Jorge, Yáñez-González Marco Antonio, García-Cruz Valeria, Loof-Esquivel Mónica, Beltrán-Tapia José Luis, Peñalva-Rosales Samuel Octavio, Vargas Hernández Víctor Manuel
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引用次数: 0

摘要

背景:分娩是胎儿、胎膜、脐带和胎盘从子宫中排出的生理过程,水分娩已成为一种流行方式,虽然患病率不详,但在足月妊娠的健康妇女中得到支持,无并发症;尽管没有足够的证据支持或反对它。目的:确定水中分娩妇女的产科和新生儿结局及并发症,并将其与传统分娩进行比较。材料和方法:这是一项回顾性、观察性和横断面研究,从2004年至2020年在私立医院接受援助的4223名妇女的数据库中纳入2486名妇女;在纳入的2486名患者中,1025名患者进行了水中分娩,1461名患者进行了常规分娩,从研究中剔除了1737名接受剖腹产的女性。从患者那里获得的信息,他们为这项研究获得的数据都是匿名的,在那里他们被分析:非参数数据以百分比报告,使用卡方;参数、围产期和新生儿数据以平均值加标准差(±SD)报告,并使用SPSS 25版统计软件包使用Student's T进行分析。结果:本研究共纳入2486例妇女,其中水中分娩1025例(24%),常规分娩1461例(35%),剖宫产1737例(41%)被排除在研究之外,产妇年龄无差异;不像体重,身高,身体质量指数;与传统分娩方式相比,在水中分娩的妇女中这一比例更高。水中分娩与常规分娩相比,无产仔(45.99%)与多产仔(53.86%)差异无统计学意义;与常规分娩相比,水分娩仅增加了剖宫产史(9.36% vs 6.5%, p=0.008),减少了流产史(16.19% vs 20.94%, p=0.002);并发症无差异:两次分娩均使用催产素(3.2 vs 3.1)或产后出血(0.29 vs 0.13);会阴一级撕裂无差异(21.4% vs 18.5%)。结论:水中分娩可减轻压力、疼痛感、二度和三度会阴撕裂伤,新生儿预后较好;选择和纳入低风险妊娠患者比传统分娩可获得更好的围产期结果;但是,需要进一步的研究来常规使用它。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Delivery in water, experiences in a population of Mexican women in Mexico City
Background: Labor is a physiological process during which the fetus, the membranes, the umbilical cord and the placenta are expelled from the uterus and water delivery has become popular, although its prevalence is unknown, it is supported by healthy women with full-term pregnancies, without complications; although there is insufficient evidence to support or discourage it. Objective: To identify obstetric and neonatal outcomes and complications in women who delivered in water and to compare them with traditional deliveries. Material and methods: It is a retrospective, observational and cross-sectional study, where 2486 women were included from a database of 4223 women assisted from 2004 to 2020 in private hospitals; Of the 2486 patients included, 1025 had a water delivery and 1461 had a conventional delivery, discarding 1737 women who underwent caesarean section from the study. The information obtained from the patients, their data obtained for this study were kept in the anonymity of the patients, where they were analyzed: non-parametric data reported in percentages using Chi square; Parametric, perinatal and neonatal data are reported as mean plus standard deviation (±SD) and analyzed using Student's T, using the SPSS version 25 statistical package. Results: A total of 2486 women were included in this study, the birth in 1025 was water delivery (24%) and 1461 was conventional delivery (35%), 1737 caesarean section (41%) were excluded from the study, no difference was observed maternal age; unlike weight, height, body mass index; they were higher in women with water birth compared to conventional. No difference was demonstrated between nulliparous (45.99%) and multiparous (53.86%) when comparing both birth in water and conventional; only increase in previous caesarean sections (9.36 vs 6.5%, p=0.008) and decrease in previous abortions (16.19 vs 20.94%, p=0.002) in water delivery with the conventional one; complications were not different: administration of oxytocin (3.2 vs 3.1) or postpartum hemorrhage (0.29 vs 0.13) in both deliveries; no differences in first degree perineal tears (21.4 vs 18.5%). Conclusion: Water birth reduces stress, pain sensation, second and third degree perineal lacerations and contributes to better newborn outcomes; the selection and inclusion of patients with low-risk pregnancies allows better perinatal results than conventional delivery; but, further studies are required to use it routinely.
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