某三级医院分娩损伤危险因素评价

M. Musharraf, Mosammat Afroza Jinnat, Sumon Shahrior Morshed, Sabira Rahman, Md Tafazzal Hossain Khan, Amit Shome, Pandora Glory, M. Banerjee
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引用次数: 1

摘要

背景:分娩创伤通常发生,特别是长时间难产或胎儿畸形。尽管随着技术的进步和产科护理的改善以及剖宫产的广泛使用,世界范围内严重的分娩创伤正在减少。评估常见的分娩创伤诱因是提供高质量产前和围产期护理以减少分娩创伤发生率和严重程度的关键因素。目的:探讨分娩创伤的危险因素。材料与方法:本病例对照研究于2018年8月14日至2019年2月14日在达卡医学院附属医院新生儿科进行。共有100名新生儿参加了这项研究。其中诊断为产伤的病例50例,无产伤的对照组50例。结果:最常见的分娩损伤为头继位损伤15(30%)。其次是脑血肿11例(22%)和盔状下出血11例(22%)。其他损伤为皮肤及软组织损伤5例(10%),其次为胸锁乳突出血、意外割伤、锁骨骨折、肱骨骨折、面神经麻痹、脑瘫、结膜下出血。机械性分娩创伤的易感因素为初产(P = 0.005)、高龄(28.99±5.4)胎龄(26.5±4.5)胎龄(P值=0.01)、胎位不良(P = 0.05)、使用催产素(P < 0.01)、产程延长(P < 0.01)、胎体较大(P =0.046)、VD(P =0.004)。结论:最常见的分娩损伤为先天性先天性损伤和初产,高龄、产程延长、婴儿体型大、胎位畸形是分娩损伤的重要危险因素。KYAMC学报第13卷第03期,2022年10月:129-133
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Evaluation of Risk Factors of Birth Injuries in a Tertiary Care Hospital
Background: Birth trauma usually occurs, particularly in long and difficult labour or fetal mal presentations. Although with advancements in technology and improved obstetric care and liberal use of cesarean section deliveries, serious birth trauma is decreasing worldwide. Appraisement of common triggers of birth trauma is the key ingredient for provision of high quality prenatal & perinatal care to reduce the incidence and severity of birth trauma.Objective: To evaluate the risk factors of birth trauma. Materials and Methods: This case control study was carried out in the department of Neonatology, Dhaka Medical College Hospital from 14th August, 2018 to 14th February, 2019. Total 100 newborns were enrolled in the study. Among them 50 were cases, diagnosed as birth injury & 50 were controlls without birth injury. Results: Most common birth injury encountered, was caput succedaneum15 (30%). The next common injuries were cephalohematoma was 11(22%) & subgalealhemorrhage 11 22%). Other injuries were skin & soft tissue injury in 5 (10%), followed by sternomastoidhemorrhage, accidental cut injury, clavicular fracture, humerus fracture, facial nerve palsy, erbs palsy, subconjunctival Haemorrhage. The predisposing factors for mechanical birth trauma were primiparity (P = 0.005), advanced maternal age (28.99 ± 5.4)> (26.5 ± 4.5) (p value =0.01), mal presentation (P = 0.05), oxytocin use (P < 0.01), Prolonged labor (P < 0.01), large size of the baby (p=0.046), VD(p=0.004). Conclusion: The study concluded that the commonest birth injury was caput succedaeneum and primiparity, advanced maternal age, prolonged labor, large-sized baby, mal presentation were the significant risk factors for birth injury. KYAMC Journal Vol. 13, No. 03, October 2022: 129-133
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