尼泊尔三级保健中心单胎足月臀位阴道分娩的孕产妇和围产期结局:回顾性分析。

IF 1.6 Q3 OBSTETRICS & GYNECOLOGY Obstetrics and Gynecology International Pub Date : 2020-11-16 eCollection Date: 2020-01-01 DOI:10.1155/2020/4039140
Tulasa Basnet, Baburam Dixit Thapa, Dipti Das, Ramesh Shrestha, Sarita Sitaula, Anu Thapa
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引用次数: 2

摘要

背景:无论分娩方式如何,臀位分娩与孕产妇和围产期发病率增加有关。足月臀位试验结果出来后,大多数国家都采用剖宫产的方式进行足月臀位分娩,因此,臀位阴道分娩越来越少见。本研究的目的是评估短期产妇和围产期结果在尼泊尔三级护理医院阴道阴道分娩。方法:回顾性分析2016年4月13日至2018年4月12日期间所有阴道臀位分娩妇女的病例记录。记录和分析可用的人口统计学变量、产科特征、分娩细节、产后并发症和围产期并发症。结果:研究期间21768例分娩中,足月臀位分娩发生率为528例(2.4%),其中阴道分娩方式仅84例(17.8%)。大多数分娩是计划外的,因为无法进行紧急剖宫产手术而进行的。3例(3.6%)发生产后出血,4例(4.8%)发生后脑积水,其中2例需要剖开 hrssen切口。不良围产儿发生率为23.8% (P=0.043)。结论:在我国现有的卫生设施条件下,阴道臀位分娩的围产儿结局严重,特别是在分娩计划不周的情况下。
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Maternal and Perinatal Outcomes of Singleton Term Breech Vaginal Delivery at a Tertiary Care Center in Nepal: A Retrospective Analysis.

Background: Breech presentation is associated with increased rates of maternal and perinatal morbidity regardless of mode of delivery. After the results of Term Breech Trial, most of the countries adopted the protocol of cesarean section for term breech delivery because of which breech vaginal delivery is becoming rare. The aim of this study is to evaluate short-term maternal and perinatal outcomes of breech vaginal delivery at a tertiary care hospital in Nepal.

Methods: A retrospective review of case records of all women who had vaginal breech delivery from April 13, 2016, to April 12, 2018, was conducted, over a period of two years. Available demographic variables, obstetric characteristics, details of labor, postpartum complications, and perinatal complications were recorded and analyzed.

Results: Out of 21,768 cases of deliveries during the study period, the incidence of term breech deliveries was 528 (2.4%) among which the mode of only 84 (17.8%) deliveries was vaginal. Most of the deliveries were unplanned and were conducted because emergency cesarean section could not be performed. Three (3.6%) women had postpartum hemorrhage, and four (4.8%) had entrapment of aftercoming head, two of them requiring Dührssen incisions. Adverse perinatal outcomes were seen in 23.8% of such deliveries with <7 APGAR score at 5 minutes in 20.2%, neonatal admission in 17.7%, and perinatal mortality in 8.3%. The perinatal mortality was significantly associated with birthweight less than 2500 grams as compared to birthweight ≥2500 grams (21.1% versus 4.6%; P=0.043).

Conclusion: The perinatal outcomes for vaginal breech delivery are grave with our existing health facilities, especially when the deliveries are not well planned.

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来源期刊
Obstetrics and Gynecology International
Obstetrics and Gynecology International OBSTETRICS & GYNECOLOGY-
CiteScore
3.60
自引率
0.00%
发文量
26
审稿时长
19 weeks
期刊介绍: Obstetrics and Gynecology International is a peer-reviewed, Open Access journal that aims to provide a forum for scientists and clinical professionals working in obstetrics and gynecology. The journal publishes original research articles, review articles, and clinical studies related to obstetrics, maternal-fetal medicine, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine and infertility, reproductive endocrinology, and sexual medicine.
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