在真空手术性阴道分娩期间,是否总是需要进行表皮切除术? 一个纵向研究研究
Antonio Ragusa1, Fernando Ficarola1, Alessandro Svelato2
1Department of Obstetrics and Gynecology, Campus Bio-Medico University Hospital Foundation Rome, Rome, Italy.
概括
在手术性阴道分娩与真空提取期间使用表皮切除术显著降低了无产妇妇女的产科关节损伤 (OASIs). 这一发现表明,在具有挑战性的分娩期间,皮切切除在预防严重的围外伤方面起着保护作用.
科学领域:
- 产科和妇科 产科和妇科
- 手术手术手术手术手术手术手术手术手术手术
- 孕产妇健康 孕产妇健康
背景情况:
- 在手术性阴道分娩 (OVB) 期间进行表皮切除术是一个有争议的程序.
- 潜在的长期,无效的后果需要评估其指示和结果.
- 产科关节损伤 (OASIs) 是OVB之后的一个重大问题.
研究的目的:
- 为了评估在真空抽取器辅助的OVB过程中表皮切开术的作用.
- 评估表皮切除术与OASI发生率之间的相关性.
- 在这种情况下,确定与OASIs相关的风险因素.
主要方法:
- 一项纵向前性观察性研究从9165例阴道分娩中招募了498例OVB病例.
- 在接受真空提取器OVB的患者中,评估了OASI发生率,并根据临床医生的裁量决定使用表皮切除术.
- 数据分析的重点是比较具有和没有表皮切割的组之间的OASI率.
主要成果:
- 在OVB总队列中,OASI发生在4%的人群中.
- 在OASIs存在的39%病例中进行了表皮切除术.
- 经过表皮切开术的OASI发病率明显低于未经表皮切开术的组 (6%) (p<0.001).与没有表皮切开术的组相比 (1.8%).
- 外皮切割显示出对OASIs的保护作用 (p=0.025整体,p=0.013在初生妇女中).
- 长时间排斥阶段 (>1小时) 是一个近乎显著的保护因素 (p=0.052).
结论:
- 在真空辅助OVB期间进行表皮切割与OASI的发病率相对较低有关,特别是在无孕妇女中 (OR 0.23,p=0.037).
- 需要用表皮切除术治疗的数量,以防止一个OASI在无孕妇女是18.
- 长时间的驱逐期是OASI的风险因素,而资金压力没有显著的影响.
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