Uotila Jukka Tapio, Taurio Kirsi, Salmelin Raili, Kirkinen Pertti
Department of Obstetrics and Gynecology, Tampere University Hospítal, Finland.
J Perinat Med. 2005;33(5):373-8. doi: 10.1515/JPM.2005.068.
To assess pre-labor attitudes and post-labor experiences of the use of vacuum extraction during delivery. To seek associations between traumatic labor experience and personal preparation, physiology of labor and treatment during labor.
A total of 205 women filled in a questionnaire within five days of vacuum extraction delivery. The questionnaire was designed to distinguish the group of women having experienced their labor as traumatic from those not having such an experience. The association between explanatory variables grouped as background factors, physiological factors of labor and treatment-related factors in relation to traumatic experience status was studied by bivariate analysis by the chi-square test or Student's t-test. Logistic regression analysis was carried out to examine simultaneous effects of factors. In the first phase, each of the previously chosen groups was analyzed separately, and in the second, all risk factors thus emerging as significant were entered into the final model.
Forty-two women (20%) regarded their childbirth experience as traumatic. Of the background factors, insufficient pre-labor training and a pre-labor desire for extra strong pain relief during the coming labor were significantly more common in the traumatic birth group. Of the physiological factors of labor, unsatisfactory pain relief and a difficult third stage of labor were associated with a traumatic birth experience. The treatment-related factors showed mutual correlation and were strongly associated with birth experience. After logistic regression analysis only four independent risk factors emerged as significant: insufficient support immediately after delivery, the experience of being poorly listened to during labor, insufficient doctor's support during the first stage of labor, and pre-labor training classes considered insufficient.
Treatment-related factors were the most powerful predictors of an adverse birth experience after vacuum extraction delivery, exceeding those related to labor physiology. Thus, the role of treatment and care before, during and after vacuum extraction is emphasized.
评估分娩期间使用真空吸引术的产前态度和产后体验。探寻创伤性分娩经历与个人准备、分娩生理及分娩期间治疗之间的关联。
共有205名女性在真空吸引术分娩后的五天内填写了一份问卷。该问卷旨在区分经历过创伤性分娩的女性群体和未经历过此类情况的女性群体。通过卡方检验或学生t检验的双变量分析，研究了归类为背景因素、分娩生理因素和与治疗相关因素的解释变量与创伤经历状态之间的关联。进行逻辑回归分析以检验各因素的同时作用。在第一阶段，分别对先前选定的每组进行分析，在第二阶段，将所有由此显示出具有显著性的风险因素纳入最终模型。
42名女性（20%）认为她们的分娩经历具有创伤性。在背景因素中，产前培训不足以及产前希望在即将到来的分娩期间获得超强疼痛缓解在创伤性分娩组中明显更为常见。在分娩生理因素方面，疼痛缓解不充分和第三产程困难与创伤性分娩经历相关。与治疗相关的因素相互关联，且与分娩经历密切相关。经过逻辑回归分析，仅四个独立风险因素显示具有显著性：产后立即获得的支持不足、分娩期间感觉未得到充分倾听、第一产程期间医生支持不足以及认为产前培训课程不足。
与治疗相关的因素是真空吸引术分娩后不良分娩经历的最有力预测因素，超过了与分娩生理相关的因素。因此，强调了真空吸引术之前、期间和之后治疗与护理的作用。
