Papamichael Esther, Aylward George William, Regan Lesley
Department of Ophthalmology, Watford General Hospital, West Hertfordshire NHS Trust , Watford , UK.
JRSM Short Rep. 2011 Mar 31;2(4):24. doi: 10.1258/shorts.2011.010107.
We sought to determine international obstetric opinions regarding the influence of a history of rhegmatogenous retinal detachment on the management of labour and to review the evidence base.
A questionnaire containing closed questions, with pre-coded response opinions, was designed to obtain a cross-section of the obstetric opinions.
Questionnaires were distributed at the 20th European Congress of Obstetrics and Gynaecology in Lisbon, Portugal.
One hundred questionnaires were distributed among obstetricians attending the congress and 74 agreed to participate.
Participants were asked to state their preferred method of delivery in such patients and the reasons for their recommendation. Furthermore, we questioned whether there was any difference in opinions depending on generation.
The majority of respondents (76%) would recommend assisted delivery (either Caesarean section or instrumental delivery), whereas the remaining 24% would advise normal delivery. Generation is not a factor influencing this decision. The majority (58%) based their decision to alter the management of labour on their personal opinion of standard of care.
The literature shows that there is little evidence to support the belief that previous retinal surgery increases the risk of re-detachment of the retina during spontaneous vaginal delivery. This short survey shows that the majority of an international sample of obstetricians questioned does not share this viewpoint. Therefore, unnecessary interventions may be occurring in otherwise fit women with a history of retinal detachment.
我们试图确定国际上产科医生对于孔源性视网膜脱离病史对分娩管理影响的看法,并回顾相关证据基础。
设计了一份包含封闭式问题及预编码回答意见的问卷,以获取产科医生意见的横断面。
问卷在葡萄牙里斯本举行的第20届欧洲妇产科学大会上分发。
向参加大会的产科医生分发了100份问卷,74人同意参与。
要求参与者说明他们对此类患者首选的分娩方式及其推荐理由。此外,我们询问了意见是否因代际不同而存在差异。
大多数受访者(76%)会推荐辅助分娩(剖宫产或器械助产),而其余24%会建议自然分娩。代际不是影响这一决定的因素。大多数人(58%)改变分娩管理的决定基于他们对护理标准的个人看法。
文献表明,几乎没有证据支持既往视网膜手术会增加自然阴道分娩时视网膜再次脱离风险这一观点。这项简短调查显示,接受询问的大多数国际产科医生样本并不认同这一观点。因此,在其他方面健康但有视网膜脱离病史的女性中可能存在不必要的干预。