产钳、实际使用情况及剖宫产预防的潜在作用：对特定墨西哥人群的研究
Forceps, Actual Use, and Potential Cesarean Section Prevention: Study in a Selected Mexican Population.
作者信息
Ayala-Yáñez Rodrigo, Bayona-Soriano Paulette, Hernández-Jimenez Arturo, Contreras-Rendón Alejandra, Chabat-Manzanera Paulina, Nevarez-Bernal Roberto
机构信息
Obstetrics and Gynecology Division, ABC Medical Center, I.A.P., Avenida Carlos Graef Fdez. 154, Santa Fe, 05300 Mexico City, Mexico ; Colegio Mexicano de Ginecología y Obstetricia (COMEGO), Torre WTC, Montecito 38-29 Of. 21, Col. Nápoles, Benito Juárez, 03810 Mexico City, Mexico.
Obstetrics and Gynecology Division, ABC Medical Center, I.A.P., Avenida Carlos Graef Fdez. 154, Santa Fe, 05300 Mexico City, Mexico.
出版信息
J Pregnancy. 2015;2015:489267. doi: 10.1155/2015/489267. Epub 2015 Aug 24.
OBJECTIVE
Assessment of the frequency of complications observed with various forceps and operative vaginal delivery (OVD) techniques performed at the ABC Medical Center (Mexico City) to evaluate their safety, bearing in mind the importance of decreasing our country's high cesarean section incidence.
METHODS
We reviewed 5,375 deliveries performed between the years 2007 and 2012, only 146 were delivered by OVD.
RESULTS
Only 1.0% of the cases had a serious, life-threatening situation (uterine rupture). The Simpson forceps was the most favored instrument (46%) due to its simplicity of use, effectiveness, and familiarity. Prophylactic use was the most common indication (30.8%) and significant complications observed were vaginal lacerations (p = 0.016), relative risk (RR) of 3.4 (95% confidence interval [CI]: 1.15-10.04), and fourth degree perineal tear (p = 0.016), RR of 3.4 (95% CI: 1.15-10.04).
CONCLUSIONS
Forceps use and other OVD techniques are a safe alternative to be considered, diminishing C-section incidence and its complications.
目的
评估在ABC医疗中心（墨西哥城）采用各种产钳及阴道助产术所观察到的并发症发生率，以评估其安全性，同时考虑到降低我国高剖宫产率的重要性。
方法
我们回顾了2007年至2012年间进行的5375例分娩，其中只有146例通过阴道助产术分娩。
结果
仅1.0%的病例出现严重的、危及生命的情况（子宫破裂）。辛普森产钳因其使用简便、有效且为人熟知而成为最常用的器械（46%）。预防性使用是最常见的指征（30.8%），观察到的显著并发症为阴道裂伤（p = 0.016），相对风险（RR）为3.4（95%置信区间[CI]：1.15 - 10.04），以及会阴四度裂伤（p = 0.016），RR为3.4（95% CI：1.15 - 10.04）。
结论
产钳使用及其他阴道助产术是一种可考虑的安全替代方法，可降低剖宫产率及其并发症。
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