剖腹产后的阴道分娩是产科关节损伤的危险因素吗?
Yoav Baruch1, Ronen Gold1, Hagit Eisenberg2,3
1Lis Hospital for Women's Health, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel.
概括
剖腹产后试图通过阴道分娩 (VBAC) 的女性与第一次通过阴道分娩的患者相比,并没有面临更高的产科关节损伤 (OASI) 风险. 这项研究在两组中发现了相似的OASI率.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 外科手术的安全性
背景情况:
- 产妇关节损伤 (OASI) 是阴道分娩的一个重要并发症.
- 剖腹产后的阴道分娩 (VBAC) 是先前剖腹产的女性越来越常见的分娩选择.
- 与原发性妇女相比,VBAC患者的OASI风险尚未得到充分确立.
研究的目的:
- 为了确定在先前剖腹产 (二胎) 后经历第一个阴道分娩的女性是否有OASI的风险增加.
- 为了比较接受VBAC的初生和二胎妇女之间的OASI发病率,风险因素和临床特征.
主要方法:
- 在10年内追溯对85,428例阴道分娩的队列研究.
- 在接受首次VBAC的初婚妇女和第二婚妇女之间的OASI率的比较.
- 多变量逻辑回归分析,以评估VBAC和OASI之间的关联.
主要成果:
- 在第二代VBAC患者 (0.94%) 和初代女性 (0.81%) 之间,OASI的发病率相似.
- 三度和四度撕裂的比例在两组之间也是可比的.
- 第二代VBAC患者的出生体重超过3500克和真空辅助分娩的比率较高,但OASI风险没有增加.
结论:
- 与初级女性相比,接受VBAC的第二夫妇女性没有观察到OASI的风险增加.
- 对于OASI风险,VBAC可以被认为是一个安全的选择.
- 进一步的研究可能会探索VBAC的其他潜在风险或好处.
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