Lawani Lucky O, Anozie Okechukwu B, Ezeonu Paul O, Iyoke Chukwuemeka A
Department of Obstetrics and Gynecology, Federal Teaching Hospital, Abakaliki, Nigeria.
Department of Obstetrics and Gynecology, Federal Teaching Hospital, Abakaliki, Nigeria.
Int J Gynaecol Obstet. 2014 Jun;125(3):206-9. doi: 10.1016/j.ijgo.2013.11.018. Epub 2014 Mar 11.
To evaluate the incidence of, indications for, and outcome of operative vaginal deliveries compared with spontaneous vaginal deliveries in southeast Nigeria.
A retrospective cohort study was conducted involving cases of operative vaginal delivery performed at Ebonyi State University Teaching Hospital over a 10-year period. Data on the procedures were abstracted from the operation notes of the medical records of parturients.
An incidence of 4.7% (n = 461) was recorded. The most common indications for vacuum and forceps delivery were prolonged second stage of labor (44.9%) and poor maternal effort (27.8%). The only indication for destructive operation was intrauterine fetal death (3.7%). The risk ratio (RR) for hemorrhage/vulvar hematoma was 1.14 (95% confidence interval [CI], 0.53-2.48) for vacuum-assisted delivery and 5.49 (95% CI, 0.82-36.64) for forceps delivery. The RR for genital laceration was 1.21 (95% CI, 0.44-3.30) for vacuum-assisted delivery and 9.41 (95% CI, 1.33-66.65) for forceps delivery. The risk of fetal scalp bruises and caput succedaneum was higher for operative vaginal delivery than for spontaneous vaginal delivery, with no significant difference in maternal morbidity. The perinatal mortality rate was 0.9 per 1000 live births.
Operative vaginal delivery by experienced healthcare providers is associated with good obstetric outcomes with minimal risk.
评估尼日利亚东南部地区手术阴道分娩与自然阴道分娩的发生率、适应证及结局。
进行一项回顾性队列研究，纳入埃邦伊州立大学教学医院10年间实施手术阴道分娩的病例。分娩过程的数据从产妇病历的手术记录中提取。
记录的发生率为4.7%（n = 461）。真空吸引和产钳助产最常见的适应证是第二产程延长（44.9%）和产妇用力不佳（27.8%）。毁胎术的唯一适应证是宫内死胎（3.7%）。真空辅助分娩出血/外阴血肿的风险比（RR）为1.14（95%置信区间[CI]，0.53 - 2.48），产钳助产为5.49（95%CI，0.82 - 36.64）。真空辅助分娩生殖器裂伤的RR为1.21（95%CI，0.44 - 3.30），产钳助产为9.41（95%CI，1.33 - 66.65）。手术阴道分娩胎儿头皮擦伤和头颅血肿的风险高于自然阴道分娩，产妇发病率无显著差异。围产儿死亡率为每1000例活产0.9例。
经验丰富的医护人员实施手术阴道分娩可获得良好的产科结局，风险极小。
