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骨盆骨折固定史是否应该是剖腹产的一个指示?
Joshua A Parry1, Katya E Strage2, Alex Lencioni2
1Department of Orthopaedics, Denver Health Medical Center, University of Colorado Medical School, Denver Health, 777 Bannock St., MC 0188, Denver, CO, 80204, USA. Joshua.parry@dhha.org.
骨盆骨折的妇女可以成功通过阴道分娩,有或没有内部固定. 这表明试产 (TOL) 是一个可行的选择,可能避免不必要的剖腹产 (CS).
科学领域:
- 产科和妇科 产科和妇科
- 创伤外科 手术 创伤外科
- 生殖健康 生殖健康
背景情况:
- 怀孕期间的骨盆骨折为分娩计划带来了独特的挑战.
- 咨询患者的分娩模式需要了解骨盆骨折及其治疗的影响.
研究的目的:
- 在患有骨盆骨折的孕妇中比较劳动试验 (TOL) 的成功率.
- 为了确定内部固定是否影响TOL成功.
- 改善患者咨询,减少不必要的剖腹产.
主要方法:
- 35名患有骨盆骨折的孕妇患者的回顾性评估.
- 骨折的分类 (骨盆环,骨骨,联合) 和治疗 (手术固定与无固定).
- 断裂分类,固定类型,传递方式以及CS的理由的文件.
主要成果:
- 总体而言,阴道分娩率为80.0%,在87.5%的尝试病例中,成功的TOL.
- 托尔的失败与Tile B/C骨盆骨折和增加的骨盆移位有关.
- 在有和没有内部固定的患者之间没有观察到TOL成功的显著差异.
结论:
- 大多数患有骨盆骨折的女性成功通过阴道分娩,不管是否固定.
- 骨盆骨折不应该自动排除一个劳动的试验.
- 这些发现支持向有资格的患者提供TOL,这些患者有骨盆骨折史.
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