阴道分娩期间的盆地损伤是改变生活和可预防的:我们可以做些什么?
John O L DeLancey1, Mariana Masteling2, Fernanda Pipitone3
1Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.
American journal of obstetrics and gynecology
|January 3, 2024
概括
出生可能会导致终身的骨盆底疾病,阴道分娩是发生和失禁的主要危险因素. 了解和肌肉损伤风险,有助于在怀孕和分娩期间做出明智的决策.
科学领域:
- 产科和妇科 产科和妇科
- 盆地健康 盆地健康
- 妇女健康 妇女健康
背景情况:
- 骨盆底疾病 (PFD) 对产后妇女产生重大影响,每年需要超过30万次手术.
- 阴道分娩是PFD的主要可修改的风险因素,如和压力失禁.
- 发生在高达19%的初发性妇女身上的关节肌肉损伤与长期的落和手术失败有关.
研究的目的:
- 阐明分娩期间升高肌肉损伤的机制和后果.
- 为了识别与和肌肉损伤相关的风险因素.
- 探索减轻与分娩相关的骨盆底创伤的潜在策略.
主要方法:
- 图像学研究的审查显示了levator ani肌肉和出生通道组织损伤.
- 风险因素的分析,包括分娩方式,产妇年龄和分娩时间.
- 讨论潜在的保护措施和产前教育策略.
主要成果:
- 在阴道分娩过程中过度拉伸,而不是压缩,会导致上升器肌肉撕裂,在55%的女性中出现后期落.
- 升降器受伤的危险因素包括子,头后部位置,晚期母亲年龄,长时间的分娩和高出生体重.
- 与其他干预措施相比,真空辅助分娩显示电梯损伤减少.
结论:
- 关节肌肉损伤是导致骨盆底疾病和缩手术失败的重要因素.
- 关于PFD风险的产前教育和分娩期间的知情决策至关重要.
- 需要进一步的研究来验证手动旋转和周围支等保护措施.
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