Challenging biases in delivery mode decisions for women with pelvic fracture history: a call for evidence-based practices and patient-centered care.

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Archives of Gynecology and Obstetrics Pub Date : 2024-10-01 Epub Date: 2024-08-31 DOI:10.1007/s00404-024-07705-w
Maya Guhan, Oluwarotimi S Nettey
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Abstract

Pelvic fractures significantly impact young individuals, with a prevalence of 20 per 100,000, leading to long-term complications such as chronic pain and genitourinary dysfunction. Notably, women with a history of pelvic fractures face increased cesarean section (C-sections) rates during childbirth. This editorial investigates the factors contributing to higher C-section rates in these women, including provider assumptions about delivery complications and systemic hospital biases. Despite these trends, evidence suggests that vaginal delivery can be successful, especially when considering factors like pelvic displacement and the timing of delivery post-fracture. We advocate for education programs to challenge provider biases, transparent patient communication, and evidence-based practices prioritizing patient-centered care. Addressing these issues can enhance maternal and fetal outcomes, supporting women in making informed decisions about their delivery options.

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挑战有骨盆骨折史的妇女在决定分娩方式时的偏见:呼吁循证实践和以患者为中心的护理。
骨盆骨折对年轻人的影响很大,发病率为十万分之二十,会导致慢性疼痛和泌尿生殖系统功能障碍等长期并发症。值得注意的是,有骨盆骨折病史的妇女在分娩时面临的剖腹产(C-sections)率会增加。这篇社论调查了导致这些产妇剖腹产率较高的因素,包括提供者对分娩并发症的假设和医院的系统性偏见。尽管存在这些趋势,但有证据表明阴道分娩是可以成功的,尤其是在考虑到骨盆移位和骨折后分娩时机等因素时。我们主张通过教育计划来挑战医疗服务提供者的偏见,与患者进行透明的沟通,并以循证实践为基础,优先考虑以患者为中心的护理。解决这些问题可以提高孕产妇和胎儿的预后,帮助妇女就分娩选择做出明智的决定。
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来源期刊
CiteScore
4.70
自引率
15.40%
发文量
493
审稿时长
1 months
期刊介绍: Founded in 1870 as "Archiv für Gynaekologie", Archives of Gynecology and Obstetrics has a long and outstanding tradition. Since 1922 the journal has been the Organ of the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. "The Archives of Gynecology and Obstetrics" is circulated in over 40 countries world wide and is indexed in "PubMed/Medline" and "Science Citation Index Expanded/Journal Citation Report". The journal publishes invited and submitted reviews; peer-reviewed original articles about clinical topics and basic research as well as news and views and guidelines and position statements from all sub-specialties in gynecology and obstetrics.
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