在真空辅助性阴道分娩期间与产科关节损伤相关的因素
Henry H Chill1,2, Aharon Dick3, Wajdy Zarka4
1Female Pelvic Medicine and Reconstructive Surgery (FPMRS), Division of Urogynecology, University of Chicago, Northshore University Health System, 9650 Gross Point Road, Suite 3900, Skokie, IL, USA. henchill@gmail.com.
International urogynecology journal
|May 4, 2024
概括
真空辅助性阴道分娩 (VAVD) 与产科关节损伤 (OASI) 有关. 关键的风险因素包括更高的妊娠年龄,胎儿痛苦和更短的手术时间,而增加的母亲年龄提供了保护.
科学领域:
- 产科和妇科 产科和妇科
- 围产儿医学 围产儿医学
- 外科手术的安全性
背景情况:
- 产妇关节损伤 (OASI) 是真空辅助性阴道分娩 (VAVD) 后的一个重大并发症.
- 识别与VAVD相关的风险因素对于改善产科结果和患者安全至关重要.
- 了解这些因素可以指导临床实践并减少OASI发生率.
研究的目的:
- 评估与OASI相关的与真空提取相关的风险因素.
- 确定在VAVD期间导致OASI的可修改和不可修改因素.
- 提供基于证据的见解,以尽量减少VAVD中的OASI率.
主要方法:
- 在一所高等大学教学医院进行了一项病例控制研究.
- 包括年龄在18-45岁的患者,接受VAVD治疗单体,长期怀孕.
- 患有OASI的病例与没有OASI (1:2比) 的对照进行了比较,分析了人口,产科和劳动参数,重点关注真空程序变量.
主要成果:
- 多变量分析确定了增加的妊娠年龄,无监督住院的表现,胎儿痛苦作为指示,以及手术持续时间小于10分钟作为OASI的显著风险因素.
- 发现增加的母亲年龄是对OASI的保护因素.
- 与OASI相关的其他因素包括分娩诱导,催产素使用,延长第二阶段,增加真空拉动次数,斜背位置,表皮切割以及更大的新生儿头周/出生体重.
结论:
- 在更高的妊娠年龄执行VAVD,以胎儿痛苦为指示,并且持续不到10分钟的程序增加了OASI风险.
- 由无监督住户进行的程序与OASI的更高风险有显著的关联.
- 增加的母亲年龄表明在VAVD期间对OASI有保护作用.
相关概念视频
Assessment of the Rectum and Anus
205
Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
205
Local Anesthetics: Clinical Application as Epidural Anesthesia
429
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
429
Appendicitis-I: Introduction
123
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
123
Esophageal Varices-I: Introduction
117
Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
117
Factors Affecting Pulmonary Ventilation
1.3K
Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
1.3K


