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非妊娠患者对分娩方式的偏好。

Non-pregnant patients' preference for delivery route.

作者信息

Thurman Andrea R, Zoller James S, Swift Steven E

机构信息

Department of Obstetrics and Gynecology, Medical University of South Carolina, Clinical Sciences Building Suite 634, 96 Jonathan Lucas Street, PO Box 250619, Charleston, SC 29425, USA.

出版信息

Int Urogynecol J Pelvic Floor Dysfunct. 2004 Sep-Oct;15(5):308-12. doi: 10.1007/s00192-004-1164-6. Epub 2004 May 14.

DOI:10.1007/s00192-004-1164-6
PMID:15580415
Abstract

The objective of the study was to survey non-pregnant women regarding their preference for obstetric delivery route and to assess their awareness of the maternal and fetal risks of obstetric delivery. We wished to determine the percentage of non-pregnant women who would choose elective cesarean section and to correlate demographic factors. We compared women who elected cesarean delivery versus vaginal delivery. All patients presenting for routine gynecologic care were asked to complete an anonymous survey. Demographic variables analyzed were patient age, race, employment, insurance type and household income. Secondary data regarding knowledge of the risks and benefits of cesarean and vaginal delivery were assessed with a Likert Scale. Of patients surveyed, 13.3% preferred cesarean section. The only significant demographic factor was was race, with 21.7% of non-whites and 7.8% of whites choosing cesarean section. Most patients agreed that elective cesarean sections should be performed and reimbursed by insurance. The majority of women answered neutral regarding the maternal and neonatal risks of obstetrical delivery. The unique feature of this observational study is the sole participation of non-pregnant patients. The percentage of women who would elect cesarean section has significant public health implications. The only difference noted between demographic groups is that non-white women had a stronger preference for cesarean. Without counseling, most women are unsure of the risks of delivery route on maternal and neonatal health.

摘要

该研究的目的是调查未怀孕女性对产科分娩方式的偏好,并评估她们对产科分娩中母婴风险的认知。我们希望确定会选择择期剖宫产的未怀孕女性的比例,并关联人口统计学因素。我们比较了选择剖宫产分娩与阴道分娩的女性。所有前来接受常规妇科护理的患者都被要求完成一项匿名调查。分析的人口统计学变量包括患者年龄、种族、就业情况、保险类型和家庭收入。关于剖宫产和阴道分娩风险与益处的知识的二级数据通过李克特量表进行评估。在接受调查的患者中,13.3%的人更喜欢剖宫产。唯一显著的人口统计学因素是种族,21.7%的非白人以及7.8%的白人选择剖宫产。大多数患者认为择期剖宫产应由保险支付费用。大多数女性对产科分娩的母婴风险回答为中立。这项观察性研究的独特之处在于仅纳入了未怀孕患者。会选择剖宫产的女性比例具有重大的公共卫生意义。不同人口统计学群体之间唯一的差异是,非白人女性对剖宫产的偏好更强。如果没有咨询,大多数女性并不清楚分娩方式对母婴健康的风险。

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引用本文的文献

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BMC Pregnancy Childbirth. 2019 Aug 9;19(1):286. doi: 10.1186/s12884-019-2440-2.
2
U.S. Nulliparas' Reasons for Expected Provider Type and Childbirth Setting.美国初产妇对预期医疗服务提供者类型和分娩环境的选择原因。
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Women's preference for caesarean section: a systematic review and meta-analysis of observational studies.

本文引用的文献

1
The influence of maternal request on the elective caesarean section rate.产妇要求对择期剖宫产率的影响。
J Obstet Gynaecol. 1998 Mar;18(2):115-9. doi: 10.1080/01443619867812.
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Revised birth and fertility rates for the United States, 2000 and 2001.2000年和2001年美国修订后的出生率和生育率。
Natl Vital Stat Rep. 2003 Feb 6;51(4):1-18.
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Informed consent and birth: protecting the pelvic floor and ourselves.知情同意与分娩:保护盆底及我们自身。
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Preferences and concerns for delivery: an antepartum survey.分娩的偏好与担忧:一项产前调查
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Prevalence and correlates of stress urinary incontinence during pregnancy: a survey at UNICAMP Medical School, São Paulo, Brazil.孕期压力性尿失禁的患病率及其相关因素:巴西圣保罗坎皮纳斯大学医学院的一项调查
Int Urogynecol J Pelvic Floor Dysfunct. 2006 May;17(3):219-23. doi: 10.1007/s00192-005-1361-y. Epub 2005 Jul 15.
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Advising prospective mothers about the maternal morbidity of vaginal childbirth.
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The likelihood of placenta previa with greater number of cesarean deliveries and higher parity.剖宫产次数越多、产次越高,前置胎盘的可能性越大。
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Consumer demand for caesarean sections in Brazil: informed decision making, patient choice, or social inequality? A population based birth cohort study linking ethnographic and epidemiological methods.巴西剖宫产的消费者需求:明智决策、患者选择还是社会不平等?一项结合人种志和流行病学方法的基于人群的出生队列研究。
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