Wongwananuruk Thanyarat, Borriboonhirunsarn Dittakarn
Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
J Med Assoc Thai. 2005 May;88(5):582-7.
To determine the incidence of vaginal breech delivery at Siriraj Hospital and to evaluate factor affecting mode of delivery.
Cross-sectional study.
Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University.
A total of 317 women with singleton breech presentation, > or =28 weeks of gestation, who had their deliveries at Siriraj Hospital during January 1st to December 31st 2003.
The medical records of these women were reviewed to determine the incidence of vaginal breech delivery. Characteristics regarding current pregnancy and delivery and maternal and fetal outcomes were evaluated, including parity, gestational age, estimate fetal weight, cervical dilation, membranes status, maternal complications, types of breech presentation, and being a private case.
The incidence of vaginal breech delivery among these women was 17.7%. Univariate analysis showed that multiparity, gestational age of <32 weeks, estimate fetal weight of < or =2500 grams, advanced cervical dilatation, ruptured membranes, and not being a private case increased the risk of vaginal breech delivery. Multiple logistic regression analysis demonstrated that only advanced cervical dilatation (4-7 cm, adjusted OR 10.7, 95% CI 3.5-33.0; >7 cm adjusted OR 40.4, 95% CI 12.6-129.2), ruptured membranes (adjusted OR 2.9, 95% CI 1.3-6.3), multiparity (adjusted OR 6.4, 95% CI 2.6-15.7), and gestational age <32 weeks (adjusted OR 9.7, 95% CI 2.7-35.7) were independently associated with vaginal breech delivery. However, lower apgar scores and neonatal complications, especially prematurity, were more frequent in vaginal than cesarean delivery.
Vaginal breech delivery was found in 17.7% of singleton breech presentation in Siriraj Hospital. Certain characteristics during labor and delivery were associated with mode of delivery including advanced cervical dilatation, ruptured membranes, multiparity, and preterm gestational age.
确定诗里拉吉医院阴道臀位分娩的发生率，并评估影响分娩方式的因素。
横断面研究。
玛希隆大学诗里拉吉医院医学院妇产科。
2003年1月1日至12月31日期间在诗里拉吉医院分娩的317名单胎臀位、孕周≥28周的妇女。
查阅这些妇女的病历以确定阴道臀位分娩的发生率。评估当前妊娠和分娩的特征以及母婴结局，包括产次、孕周、估计胎儿体重、宫颈扩张、胎膜状况、母亲并发症、臀位类型以及是否为自费病例。
这些妇女中阴道臀位分娩的发生率为17.7%。单因素分析显示，经产妇、孕周<32周、估计胎儿体重≤2500克、宫颈扩张进展、胎膜破裂以及非自费病例会增加阴道臀位分娩的风险。多因素逻辑回归分析表明，只有宫颈扩张进展（4 - 7厘米，校正比值比10.7，95%可信区间3.5 - 33.0；>7厘米，校正比值比40.4，95%可信区间12.6 - 129.2）、胎膜破裂（校正比值比2.9，95%可信区间1.3 - 6.3）、经产妇（校正比值比6.4，95%可信区间2.6 - 15.7）和孕周<32周（校正比值比9.7，95%可信区间2.7 - 35.7）与阴道臀位分娩独立相关。然而，阴道分娩的阿氏评分较低和新生儿并发症，尤其是早产，比剖宫产更常见。
在诗里拉吉医院，17.7%的单胎臀位分娩为阴道臀位分娩。分娩过程中的某些特征与分娩方式有关，包括宫颈扩张进展、胎膜破裂、经产妇和早产孕周。
