Hadar Eran, Raban Oded, Gal Bracha, Yogev Yariv, Melamed Nir
Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel.
J Matern Fetal Neonatal Med. 2012 Oct;25(10):2055-7. doi: 10.3109/14767058.2012.678438. Epub 2012 Apr 21.
To determine whether introducing a pre-prepared birth plan upon labor admission has an impact on obstetrical outcome.
A retrospective study of all women who prepared an ante-partum birth plan, from 2007-2010. Outcome was compared with a control group consisting of women without a birth plan matched by age, parity and gestational week in a 3:1 ratio.
154 women were compared to a matched control group of 462 women. Women preparing a birth plan, were less likely to undergo an intra partum cesarean section (11.7% vs. 20.3%, p = 0.016). First and second degree perineal tears occurred more frequently in women preparing a birth plan (72.1% vs. 25.5%, p < 0.001). The utilization of birth plan was also associated with a higher rate of epidural administration (81.2% vs. 68.8%, p = 0.004) and a lower rate of intravenous analgesics use (1.3% vs. 10.2%, p < 0.001).
Women presenting with a birth plan, compared to an age-, parity- and gestational week- matched control group are less likely to undergo a cesarean section, more likely to have first and second degree perineal tears and more likely to use an epidural. The paucity of data and the mis-concepts of medical staff suggest that larger prospective studies are needed.
确定分娩入院时引入预先制定的分娩计划是否会对产科结局产生影响。
对2007年至2010年期间所有制定产前分娩计划的女性进行回顾性研究。将结局与一个由未制定分娩计划的女性组成的对照组进行比较，对照组按年龄、产次和孕周以3:1的比例匹配。
154名女性与462名匹配的对照组女性进行了比较。制定分娩计划的女性接受产时剖宫产的可能性较小（11.7%对20.3%，p = 0.016）。制定分娩计划的女性发生一度和二度会阴撕裂的频率更高（72.1%对25.5%，p < 0.001）。分娩计划的使用还与更高的硬膜外给药率（81.2%对68.8%，p = 0.004）和更低的静脉镇痛药物使用率（1.3%对10.2%，p < 0.001）相关。
与年龄、产次和孕周匹配的对照组相比，制定分娩计划的女性剖宫产的可能性较小，一度和二度会阴撕裂的可能性更大，使用硬膜外麻醉的可能性更大。数据的匮乏和医务人员的误解表明需要进行更大规模的前瞻性研究。
