大多発症の女性における緊急帝王切開の予測要因は,大多発症および多発症の女性と比較した
Roza Berkovitz Shperling1,2, Liat Lerner-Geva3,4, Gal Ariel1,2
1Department of Obstetrics and Gynecology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
まとめ
グランド・マルチペアスの女性は,他の対等性グループと比較して,緊急帝王切開 (CS) のリスクが低い. 緊急CSの主要な予測要因には,人工生殖技術,長時間膜破裂,喫煙,糖尿病などがあります.
科学分野:
- 産婦人科と産婦人科を担当しています.
- 妊産婦・胎児医学について
- 生殖器保健は,生殖器の健康についてです.
背景:
- パリティは,妊娠の結果と出産方法に大きな影響を与えます.
- 5人以上出産した女性として定義されるグランドマルチパルース (GMP) 女性は,産科の異なるグループを表しています.
- GMPの女性における緊急帝王切開 (CS) リスク要因を理解することは,母と新生児のケアを最適化するために極めて重要です.
研究 の 目的:
- グランドマルチパラス (GMP) の女性における緊急CSの予測要因を特定する.
- GMP,多発性 (MP),および初発性 (PP) の女性間の緊急CS率と関連する要因を比較する.
- GMPの妊娠における緊急CSの主な徴候を解明する.
主な方法:
- 2011年から2018年の間に生きたまま生まれた74,848人のシングルトンの遡及的なコホート研究.
- 女性は,原発性 (PP),多発性 (MP, 2-4 出産),および大多発性 (GMP, ≥5 出産) グループに分類されました.
- 多変数ロジスティック回帰では,緊急のCSに関連した要因を分析し,妊娠年齢によって層分化しました.
主要な成果:
- 緊急CSの割合は,PPで最高 (13.2%),MPで最下 (9.4%),GMPで最下 (6.5%) でした.
- 緊急CSの独立予測要因には,助産生殖技術 (aOR=2.09),長時間膜破裂の潜伏時間 (aOR=2.08),喫煙 (aOR=1.49),糖尿病 (aOR=1.46) が含まれていた.
- 安心させない胎児の心拍数は,GMPの女性 (71.1%) の緊急CSの主要な徴候でした.
結論:
- 大多発性女性は,初発性および多発性女性と比較して,緊急CSのリスクが低い.
- 助産生殖技術,長時間膜破裂の潜伏時間,喫煙,糖尿病は,緊急のCSの重要な独立した予測要因です.
- 安心させない胎児の心拍数は,グランド多胎妊娠における緊急CSの主要な徴候である.
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