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坦桑尼亚布甘多医疗中心潜伏期入院孕妇与活跃期入院孕妇的劳动管理及产科结局比较

Labour management and Obstetric outcomes among pregnant women admitted in latent phase compared to active phase of labour at Bugando Medical Centre in Tanzania.

作者信息

Chuma Clotrida, Kihunrwa Albert, Matovelo Dismas, Mahendeka Marietha

机构信息

Department of Obstetrics & Gynecology, Catholic University of Health & Allied sciences, P,O,BOX 1464, Mwanza, Tanzania.

出版信息

BMC Pregnancy Childbirth. 2014 Feb 12;14:68. doi: 10.1186/1471-2393-14-68.

Abstract

BACKGROUND

Interventions given to women admitted in latent or active phase of labor may influence the outcomes of labor and ameliorate complications which can affect the mother and fetus. Labour management, maternal and fetal outcomes among low risk women presenting both in latent phase and active phase of labour in Tanzania have not recently been explored.

METHODS

This was a descriptive cross-sectional study. It was done from February to April 2013. Case notes were collected serially until the sample size was reached. A structured checklist was used to extract data. Data was analyzed using SPSS version 17. A p < 0.05 was considered significant at 95% confidence interval.

RESULTS

Five hundred case notes of low risk pregnant women were collected, half of each presented in latent phase and active phase of labour. Key interventions including augmentation with oxytocin, artificial rupture of membranes and caesarean section were significantly higher in the latent phase group than the active phase group 84(33.6%) versus 52(20.8%) p < 0.05; 96(38.6%) versus 56(22.4%) p < 0.05 and 87(34.8%) versus 60(24.0%) p < 0.05 respectively. Spontaneous vertex delivery was higher among pregnant women admitted initially in active phase than in latent phase groups 180(72.0%), versus 153(61.2%) p > 0.01). There were more women in the active phase group who sustained genital tract tear and postpartum haemorrhage than in the latent phase group 101(18.6%), versus 38(15.6%) p < 0.01 and 46(18.4%), versus 17(6.6%) p < 0.05 respectively.

CONCLUSIONS

Pregnant women admitted at BMC in latent phase of labour are subjected to more obstetric interventions than those admitted in the active phase. There is need to produce guidelines on management of women admitted in latent phase of labour at BMC to reduce the risk of unnecessary interventions.

摘要

背景

对处于潜伏期或活跃期分娩的女性进行的干预措施可能会影响分娩结局,并改善可能影响母亲和胎儿的并发症。坦桑尼亚低风险女性在分娩潜伏期和活跃期的分娩管理、母婴结局最近尚未得到探讨。

方法

这是一项描述性横断面研究。研究于2013年2月至4月进行。连续收集病例记录,直至达到样本量。使用结构化检查表提取数据。使用SPSS 17版软件进行数据分析。在95%置信区间,p<0.05被认为具有统计学意义。

结果

收集了500份低风险孕妇的病例记录,每组各有一半处于分娩潜伏期和活跃期。潜伏期组包括使用缩宫素加强宫缩、人工破膜和剖宫产在内的关键干预措施显著高于活跃期组,分别为84例(33.6%)对52例(20.8%),p<0.05;96例(38.6%)对56例(22.4%),p<0.05;87例(34.8%)对60例(24.0%),p<0.05。最初入院时处于活跃期的孕妇自然头位分娩率高于潜伏期组,分别为180例(72.0%)对153例(61.2%),p>0.01)。活跃期组发生生殖道撕裂和产后出血的女性多于潜伏期组,分别为101例(18.6%)对38例(15.6%),p<0.01;46例(18.4%)对17例(6.6%),p<0.05。

结论

在BMC医院入院时处于分娩潜伏期的孕妇比活跃期入院的孕妇接受更多的产科干预。有必要制定关于BMC医院分娩潜伏期入院女性管理的指南,以降低不必要干预的风险。

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