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英格兰西南部妇产科医生的个人分娩偏好及实际分娩方式结果;与地区和国家分娩统计数据的比较。

Personal birth preferences and actual mode of delivery outcomes of obstetricians and gynaecologists in South West England; with comparison to regional and national birth statistics.

作者信息

Lightly Katie, Shaw Elisabeth, Dailami Narges, Bisson Dina

机构信息

Speciality Trainee in Obstetrics and Gynaecology, North Bristol NHS Trust, Southmead Hospital, Bristol, BS10 5NB, United Kingdom.

Consultant Obstetrician and Gynaecologist. Arrowe Park Hospital, Wirral, Merseyside, CH49 5PE.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2014 Oct;181:95-8. doi: 10.1016/j.ejogrb.2014.07.005. Epub 2014 Jul 30.

Abstract

OBJECTIVE

To determine personal birth preferences of obstetricians in various clinical scenarios, in particular elective caesarean section for maternal request. To determine actual rates of modes of deliveries amongst the same group. To compare the obstetrician's mode of delivery rates, to the general population.

STUDY DESIGN

Following ethical approval, a piloted online survey link was sent via email to 242 current obstetricians and gynaecologists, (consultants and trainees) in South West England. Mode of delivery results were compared to regional and national population data, using Hospital Episode Statistics and subjected to statistical analysis.

RESULTS

The response rate was 68%. 90% would hypothetically plan a vaginal delivery, 10% would consider a caesarean section in an otherwise uncomplicated primiparous pregnancy. Of the 94/165 (60%) respondents with children (201 children), mode of delivery for the first born child; normal vaginal delivery 48%, caesarean section 26.5% (elective 8.5%, emergency 18%), instrumental 24.5% and vaginal breech 1%. Only one chose an elective caesarean for maternal request. During 2006-2011 obstetricians have the same overall actual modes of birth as the population (p=0.9).

CONCLUSIONS

Ten percent of obstetricians report they would consider requesting caesarean section for themselves/their partner, which is the lowest rate reported within UK studies. However only 1% actually had a caesarean solely for maternal choice. When compared to regional/national statistics obstetricians currently have modes of delivery that are not significantly different than the population and suggests that they choose non interventional delivery if possible.

摘要

目的

确定产科医生在各种临床情况下的个人分娩偏好,特别是因产妇要求而进行的选择性剖宫产。确定同一组人群中实际的分娩方式比例。将产科医生的分娩方式比例与普通人群进行比较。

研究设计

在获得伦理批准后,通过电子邮件向英格兰西南部的242名现任产科医生和妇科医生(顾问和实习生)发送了一份经过试点的在线调查链接。使用医院事件统计数据将分娩方式结果与地区和国家人口数据进行比较,并进行统计分析。

结果

回复率为68%。假设情况下,90%的人会计划顺产,10%的人会考虑在其他方面无并发症的初产妇妊娠中进行剖宫产。在有孩子的94/165名(60%)受访者(201名儿童)中,第一个孩子的分娩方式;正常阴道分娩占48%,剖宫产占26.5%(选择性剖宫产占8.5%,急诊剖宫产占18%),器械助产占24.5%,臀位阴道分娩占1%。只有一人因产妇要求选择了选择性剖宫产。在2006 - 2011年期间,产科医生的总体实际分娩方式与普通人群相同(p = 0.9)。

结论

10%的产科医生报告他们会考虑为自己/其伴侣要求剖宫产,这是英国研究中报告的最低比例。然而,实际上只有1%的人仅因产妇选择而进行了剖宫产。与地区/国家统计数据相比,目前产科医生的分娩方式与普通人群没有显著差异,这表明他们在可能的情况下会选择非干预性分娩。

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