社区医院系统中经产妇引产的并发症

Complications of labor induction among multiparous women in a community-based hospital system.

作者信息

Battista Leah, Chung Judith H, Lagrew David C, Wing Deborah A

机构信息

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Irvine, School of Medicine, Orange, USA.

出版信息

Am J Obstet Gynecol. 2007 Sep;197(3):241.e1-7; discussion 322-3, e1-4. doi: 10.1016/j.ajog.2006.12.027.

DOI:10.1016/j.ajog.2006.12.027

PMID:17826404

Abstract

OBJECTIVE

The purpose of this study was to examine complications of labor induction compared to spontaneous labor in multiparas.

STUDY DESIGN

This was a retrospective cohort study of multiparous women with live, singleton pregnancies at term, who had no contraindications to labor or labor induction. Cesarean delivery was the primary outcome.

RESULTS

Of the study subjects, 7208 experienced spontaneous labor, 2190 underwent labor induction with oxytocin, and 239 underwent labor induction requiring cervical ripening agents. Oxytocin-induced multiparas were 37% more likely to require cesarean compared to those with spontaneous labor (OR, 1.37; 95% CI, 1.10-1.71) and nearly 3 times more likely to undergo cesarean when cervical ripening agents were used (OR, 2.82; 95% CI, 1.84-4.53). Women requiring cervical ripening were also 10 times more likely to spend more than 12 hours in labor than those with spontaneous labor.

CONCLUSION

Multiparas undergoing labor induction are at increased risk for obstetric complications compared to spontaneous labor.

摘要

目的

本研究旨在比较经产妇引产与自然分娩的并发症情况。

研究设计

这是一项对足月单胎活产经产妇的回顾性队列研究，这些产妇无引产或分娩的禁忌证。剖宫产是主要结局。

结果

在研究对象中，7208例经历自然分娩，2190例接受缩宫素引产，239例接受需要宫颈成熟剂的引产。与自然分娩的经产妇相比，缩宫素引产的经产妇剖宫产的可能性高37%（比值比，1.37；95%可信区间，1.10 - 1.71），使用宫颈成熟剂时剖宫产的可能性高出近3倍（比值比，2.82；95%可信区间，1.84 - 4.53）。与自然分娩的产妇相比，需要宫颈成熟的女性产程超过12小时的可能性也高出10倍。