会阴侧切助产分娩时产道裂伤的部位及发生率
Site and incidence of birth canal lacerations from instrumental delivery with mediolateral episiotomy.
作者信息
Chikazawa Kenro, Ushijima Junko, Takagi Kenjiro, Nakamura Eishin, Samejima Koki, Kadowaki Kanako, Horiuchi Isao
机构信息
Saitama Medical Center, Jichi Medical University, Perinatal Center, Division of Maternal Fetal Medicine, Saitama, Japan.
Saitama Medical Center, Jichi Medical University, Perinatal Center, Division of Maternal Fetal Medicine, Saitama, Japan.
出版信息
Taiwan J Obstet Gynecol. 2016 Dec;55(6):861-862. doi: 10.1016/j.tjog.2016.05.011.
OBJECTIVE
Instrument-assisted vaginal delivery is a significant risk factor for birth canal lacerations. Although many obstetricians recently are recommending restrictive rather than a routine episiotomy, reports have shown restrictive episiotomy to be associated with more extensive anterior birth canal trauma compared with routine episiotomy.
MATERIALS AND METHODS
We retrospectively reviewed 110 cases of forceps and vacuum deliveries and investigated the site of birth canal lacerations. Birth canal lacerations were divided into four sites according to direction-anterior, ipsilateral, contralateral, and posterior.
RESULTS
The frequency of lacerations were, from most to least, posterior (34%), lateral (21.7%), and anterior (1.9%). Moreover, among the lateral lacerations, they were more frequent in the contralateral side of episiotomy than the ipsilateral side (18.9% vs. 4.7%, p < 0.01).
CONCLUSION
Our results indicate that caution is also needed concerning not only the anterior site, but also the contralateral site of an episiotomy to prevent laceration in an instrument-assisted vaginal delivery.
目的
器械辅助阴道分娩是产道裂伤的一个重要危险因素。尽管近来许多产科医生建议采用限制性而非常规会阴切开术，但报告显示，与常规会阴切开术相比，限制性会阴切开术与更广泛的产道前部创伤有关。
材料与方法
我们回顾性分析了110例产钳和真空吸引分娩病例，并调查了产道裂伤的部位。根据方向，产道裂伤分为四个部位——前部、同侧、对侧和后部。
结果
裂伤发生频率由高到低依次为后部（34%）、侧部（21.7%）和前部（1.9%）。此外，在侧部裂伤中，对侧会阴切开术侧比同侧更常见（18.9%对4.7%，p<0.01）。
结论
我们的结果表明，在器械辅助阴道分娩中，不仅要注意前部，还要注意会阴切开术的对侧部位，以防止裂伤。
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