面对恐惧:我们的臀位阴道分娩经验--回顾性分析

S. D. Poddar, Santhanam Sampath, Shikha Sharma, Mohammad Rasheed, Amarinder Singh, Ricky Saini
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摘要

导言:数十年来,临产单胎臀位分娩方式一直是一个激烈讨论的话题,现在依然如此。临产臀位试验 "对阴道臀位分娩是一个沉重的打击,导致全世界剖腹产率急剧上升。我们打算比较和评估阴道臀位分娩与剖腹产的产妇和围产期结果,从而分析臀位分娩阴道分娩的安全性:分析和比较足月或近足月单胎臀位分娩中阴道分娩与剖宫产的围产期和产妇结局:回顾性比较 2015 年 1 月至 2022 年 1 月期间在多家军队医院进行的 30 例阴道臀位分娩(第 1 组)和 252 例剖宫产分娩(第 2 组)之间的差异:采用卡方检验(Chi-square test)和费雪精确检验(Fisher exact test)估计产妇和围产期结果之间的关系,P < 0.05 为差异有统计学意义:结果:第 1 组未发现产妇并发症,而第 2 组分别有 14% 和 7% 的产妇出现不同程度的手术部位感染和产后出血,差异有统计学意义。在新生儿预后和新生儿重症监护室入院率方面,两组之间没有明显差异:结论:在设备完善的医疗中心,在经验丰富的产科医生的指导下,经阴道分娩治疗一胎臀位妊娠是一个合理的选择。
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Confronting the Fear: Our Experience with Breech Vaginal Delivery-A Retrospective Analysis
Introduction: Mode of delivery for term singleton breech presentation has been a raging topic of discussion for decades and continues to be so. The ‘Term Breech Trial’ was a big blow to vaginal breech delivery leading to a torrential increase in the rate of caesarean sections the world over. We intend to compare and evaluate the maternal and perinatal outcomes of vaginal versus caesarean section breech delivery so as to analyse the safety of vaginal delivery for breech presentation. Objectives: Analyse and compare perinatal and maternal outcomes between vaginal versus caesarean deliveries of term or near-term singleton breech presentation. Materials and Methods: Retrospective comparison between 30 vaginal breech deliveries (Group 1) and 252 caesarean deliveries (Group 2) done for singleton breech presentation between 36 weeks to 42 weeks, either in early or advanced labour conducted between January 2015-January 2022 at various Military Hospitals. Statistical Analysis: The association between maternal and perinatal outcomes was estimated using the Chi-square test and Fisher exact test with P < 0.05 considered statistically significant. Results: No maternal complications were noted in Group 1 while in Group 2 surgical site infection and post-partum haemorrhage of varying degree, was noted in 14% cases and 7% cases respectively which was statistically significant. There was no significant difference noted between the groups with regard to neonatal outcomes or NICU admission. Conclusion: Vaginal delivery for termsingleton breech is a reasonable option in well-selected patients at optimally equipped centres, in the hands of an experienced Obstetrician.
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