经阴道试产与计划剖宫产对三胎妊娠产妇及新生儿结局的影响
Maternal and neonatal outcomes in triplet gestations by trial of labor versus planned cesarean delivery.
作者信息
Peress Danielle, Dude Annie, Peaceman Alan, Yee Lynn M
机构信息
a Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Perelman School of Medicine , University of Pennsylvania , Philadelphia , PA , USA.
b Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Feinberg School of Medicine , Northwestern University , Chicago , IL , USA.
出版信息
J Matern Fetal Neonatal Med. 2019 Jun;32(11):1874-1879. doi: 10.1080/14767058.2017.1421931. Epub 2018 Jan 7.
OBJECTIVE
To determine the rate of vaginal delivery after vaginal trial of labor (TOL) among women with triplet gestations.
STUDY DESIGN
This is a retrospective cohort study of all women delivering a viable triplet gestation between 2005 and 2016. The primary outcome was rate of vaginal delivery among all women attempting vaginal delivery. Secondary outcomes included factors associated with undergoing triplet TOL, and maternal and neonatal complications by planned delivery approach.
RESULTS
Of the 83 eligible women, 21 (25.3%) underwent TOL. A majority of these (57.1, 95% confidence interval 36.5-75.5%) achieved a vaginal delivery of all three triplets. Women who underwent TOL were more likely to be multiparous or to have spontaneous preterm labor. There were no differences in adverse maternal or neonatal outcomes by planned delivery approach.
CONCLUSIONS
The rate of vaginal delivery among women with triplet gestations is higher in this institution than in reported literature, without increased morbidity.
目的
确定三胎妊娠妇女经阴道试产（TOL）后的阴道分娩率。
研究设计
这是一项对2005年至2016年间所有分娩存活三胎妊娠妇女的回顾性队列研究。主要结局是所有尝试阴道分娩妇女的阴道分娩率。次要结局包括与三胎TOL相关的因素，以及按计划分娩方式的母婴并发症。
结果
在83名符合条件的妇女中，21名（25.3%）接受了TOL。其中大多数（57.1%，95%置信区间36.5 - 75.5%）实现了三胞胎全部经阴道分娩。接受TOL的妇女更可能是经产妇或发生自发性早产。按计划分娩方式，母婴不良结局无差异。
结论
该机构三胎妊娠妇女的阴道分娩率高于文献报道，且发病率未增加。
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