Varawalla N, Settatree R
Solihull Maternity Unit, Birmingham Heartlands and Solihull Hospitals NHS Trust, UK.
J Obstet Gynaecol. 1998 Nov;18(6):520-3. doi: 10.1080/01443619866237.
We have investigated whether the attending obstetrician has an influence on the mode of operative delivery by examining practices of obstetricians working at a district general hospital in the United Kingdom over 3 years. Nulliparous women ( n = 1410) with a singleton, cephalic and term fetus who had an operative delivery were studied. The most senior obstetrician present at 89% of these deliveries was one of the 12 registrars training in the unit. The proportion of women delivered by each mode of vaginal or abdominal operative delivery by each registrar was compared. In nine of these registrars the proportion of women they delivered by at least one mode differed significantly from the others. Caesarean section after an unsuccessful attempt at operative vaginal delivery showed the largest variation and caesarean section before the second stage of labour showed the least, with vaginal operative delivery modes and caesarean section in the second stage without a trial of vaginal delivery intermediate between the two. The method can be used to provide a 'profile' of the preferences exercised by individual operators.
我们通过对英国一家地区综合医院的产科医生三年来的工作实践进行调查，研究了主治产科医生是否会对手术分娩方式产生影响。对有单胎、头位且足月胎儿并接受手术分娩的初产妇（n = 1410）进行了研究。在这些分娩中，89% 的分娩时在场的最高年资产科医生是该科室接受培训的12名住院医师之一。比较了每位住院医师通过每种阴道或腹部手术分娩方式分娩的女性比例。在这些住院医师中，有9位通过至少一种方式分娩的女性比例与其他医师有显著差异。经阴道手术分娩尝试失败后行剖宫产的差异最大，而在第二产程前剖宫产的差异最小，阴道手术分娩方式和第二产程中未尝试阴道分娩而行剖宫产的差异介于两者之间。该方法可用于提供个体手术医生偏好的“概况”。
