评估两种不同的培训干预措施对改善阴道双胞胎出生率和提供者信心和知识水平的影响:干预前后的研究
Claudio Celentano1,2,3, Barbara Matarrelli4, Maurizio Rosati1,2
1Department of Obstetrics and Gynecology, Santo Spirito Hospital, Affiliated University G. d'Annunzio Chieti-Pescara, Pescara, Italy.
概括
在实施专业培训和专家团队后,双胞胎的阴道分娩率显著增加. 这种干预改善了提供者信心和技能,但没有对母亲或新生儿的结果产生负面影响.
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
- 围产期护理 围产期护理
背景情况:
- 在全球范围内,多胎妊娠的剖腹产率正在上升.
- 双胞胎怀孕的阴道分娩经常被考虑,但并不总是追求.
- 有证据表明,双胞胎的阴道分娩可能是安全和可行的.
研究的目的:
- 评估针对性干预对增加双胞胎怀孕阴道分娩率的影响.
- 评估干预后对母亲和新生儿的结果.
- 为了衡量医疗保健提供者对阴道双胞胎分娩的信心和技能水平.
主要方法:
- 追溯多中心研究,比较两家意大利医院干预前后结果.
- 干预涉及专家团队和临床医生和助产士的季度培训.
- 包括双胞胎,可活的双胞胎≥34周怀孕与头部第一双胞胎;278名妇女分析.
主要成果:
- 阴道分娩率从9.2%上升到整体的40.8%.
- 没有观察到对母亲或新生儿结局的不良影响.
- 提供者报告说,在管理阴道双胞胎出生时,他们的信心,知识和技能增加了.
结论:
- 即使在高剖腹产设置中,也可以实现双胞胎阴道分娩率的快速增加.
- 员工培训或专业团队可以在不影响安全的情况下促进这种增加.
- 模拟和技能培训提高了提供者的能力,并影响了临床实践.
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