母体希望による帝王切開とロブソン分類
Cristine Moreira Silva Benetti1, Célia José Laice Sitoe Muhandule1, Laura Bianchini Fogulin1
1School of Medical Sciences, University of Campinas (Unicamp), Campinas, São Paulo, Brazil.
まとめ
母体希望による帝王切開(CDMR)は全分娩の5.4%を占め、主にロブソン分類グループ5.1に分類される。CDMR患者の大多数は高血圧や糖尿病などの併存疾患を抱えており、現在の分類システムの限界を浮き彫りにしている。
科学分野:
- 産科および婦人科
- 母体胎児医学
- 公衆衛生
背景:
- 母体希望による帝王切開(CDMR)は、世界的に定義が異なる複雑な問題である。
- CDMRの有病率と特性を理解することは、妊産婦医療にとって極めて重要である。
- ロブソン分類(RC)は、帝王切開のパターンを分析するために使用されるツールである。
主な方法:
- ブラジルのハイリスク産科病院(2017年10月~2021年10月)の電子分娩記録を用いて横断研究を実施した。
- CDMR症例は、選択的(CDMRele)、誘発中止(CDMRiw)、分娩中止(CDMRlw)に分類された。
- RCグループ内での分布と関連する併存疾患についてデータを分析した。
結論:
- CDMRを取り巻く定義と状況には、国際的なコンセンサスが欠如している。
- ロブソン分類は、特に併存疾患の有病率が高い集団において、CDMRという現象を完全に捉える上で限界がある。
- ブラジルの法律では、国際的な文献で以前確立されていなかった状況でのCDMRが許可されている。
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