在医院之间进行的红色剖腹产产后的孕产妇和产周结局,医院的护理水平不同
Anna Locatelli1, Giuseppe Marino2, Enrico Corno3
1Department of Medicine and Surgery, University of Milano-Bicocca, MI, Italy; IRCCS San Gerardo dei Tintori, Monza, MB, Italy.
European journal of obstetrics, gynecology, and reproductive biology
|November 23, 2024
概括
代码红色剖腹产 (CD) 的结果与适宜性有关,而不是决定到分娩的间隔. 一级医院,尽管较少适当的指示,显示出更好的产周结局比二级单位在紧急CD.
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
- 手术结果研究研究
背景情况:
- 红色剖腹产 (CD) 是对即将发生的孕产妇或胎儿危险的关键干预.
- 需要进一步澄清红色代码CD的指示,时间和程序.
- 评估影响红码CD结果的因素对于改善产科护理至关重要.
研究的目的:
- 评估医院护理水平,指示和决定到分娩间隔 (DDI) 对孕产妇和围产期结局的影响.
- 为了比较不同级别的产科单位 (一级与二级) 之间的结果.
- 确定与紧急剖腹产中不良围产结果相关的关键因素.
主要方法:
- 对168张红色密码CD (2018-2021) 的多中心回顾性研究.
- 包括四个产妇单位的数据:两个2级大学医院和两个1级社区医院.
- 由独立专家进行的回顾性审计,以评估指示的适当性.
主要成果:
- 严重异常的胎儿心率模式 (41.7%) 和哨兵事件 (38.1%) 是最常见的迹象.
- 决策到分娩间隔 (DDI) 在各医院水平上是相似的,并没有影响围产期结果.
- 与一级医院相比,二级医院的适合症率较高 (80.2%对65%),但围产期结果较差 (43.4%对21.1%).
- 多变量分析表明,代码红色CD和2级单位的指示独立地与更差的围产期结局有关.
结论:
- 一级医院提供迅速的紧急剖腹产反应,与二级医院相美.
- 红色代码CD的适用性,而不是DDI,与不良围产期结局有显著的相关性.
- 尽管有较高的适合性指示率,但Level-2单位表现出较差的围产期结局,这表明需要进一步调查护理方案.
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