界定产科肛门括约肌撕裂的高危人群。
Defining an at-risk population for obstetric anal sphincter laceration.
作者信息
Minaglia Steven M, Kimata Chieko, Soules Karen A, Pappas Tamara, Oyama Ian A
机构信息
Department of Obstetrics and Gynecology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
出版信息
Am J Obstet Gynecol. 2009 Nov;201(5):526.e1-6. doi: 10.1016/j.ajog.2009.07.021. Epub 2009 Sep 17.
OBJECTIVE
The purpose of this study was to calculate the number of cesarean deliveries needed to prevent 1 case of obstetric anal sphincter laceration associated with operative vaginal delivery in an at-risk cohort.
STUDY DESIGN
An institutional, computerized database was used to analyze women with obstructed labor who could have been managed by either operative vaginal or cesarean delivery from September 2006 to March 2008. Women with 1 or more of the following diagnoses comprised the cohort: cephalopelvic disproportion (CPD), arrest of descent, maternal exhaustion, and fetal distress.
RESULTS
Fifty (23.9%) out of a total of 209 women managed by operative vaginal delivery experienced an anal sphincter laceration compared to none of 254 women in the cesarean delivery group (P < .0001). The ARR therefore was 23.9% (95% confidence interval, 18.1-29.7) and the NNT was 4.2 (95% confidence interval, 3.4-5.5).
CONCLUSION
Five cesarean deliveries are needed to prevent 1 anal sphincter laceration associated with operative vaginal delivery in this cohort.
目的
本研究旨在计算在一个高危队列中，为预防1例与手术助产相关的产科肛门括约肌裂伤所需的剖宫产数量。
研究设计
利用一个机构的计算机化数据库，分析2006年9月至2008年3月期间可能接受手术助产或剖宫产的产程受阻妇女。具有以下1种或多种诊断的妇女组成该队列：头盆不称（CPD）、产程停滞、产妇衰竭和胎儿窘迫。
结果
在209例接受手术助产的妇女中，有50例（23.9%）发生了肛门括约肌裂伤，而剖宫产组的254例妇女中无一例发生（P <.0001）。因此，绝对危险度降低（ARR）为23.9%（95%置信区间，18.1 - 29.7），需要治疗的人数（NNT）为4.2（95%置信区间，3.4 - 5.5）。
结论
在该队列中，需要进行5次剖宫产才能预防1例与手术助产相关的肛门括约肌裂伤。
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