Department of Obstetrics and Gynaecology, Mulago National Referral Hospital, Kampala, Uganda.
Department of Obstetrics and Gynaecology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.
Trop Med Int Health. 2018 Aug;23(8):914-922. doi: 10.1111/tmi.13089. Epub 2018 Jun 29.
To assess perceptions of women undergoing vacuum extraction or second-stage caesarean section (SSCS) in a tertiary referral hospital in sub-Saharan Africa.
Prospective cohort study, with six-month follow-up, of women who gave birth to a term singleton in cephalic presentation by vacuum extraction (n = 289) or SSCS (n = 357) between 25 November 2014, to 8 July 2015, in Mulago Hospital, Uganda. Excluded were women who had failed vacuum extraction, severe birth complications and those whose babies had died. Outcome measures were birthing experience satisfaction, physical component summary (PCS) and mental component summary (MCS) of the SF-12 quality-of-life questionnaire, pain scores and dyspareunia.
One day after vacuum extraction, 63.7% (181/284) of women were feeling well vs. 48.1% (167/347) after SSCS (OR 1.89; 95%CI 1.37-2.61) and mean pain sores were 2.70 vs. 3.87 (P < 0.001). In both groups, >90% of women were satisfied with their birthing experience. At six weeks, in vacuum extraction vs. SSCS, mean pain sores were 0.40 vs. 0.89 (P < 0.001); mean PCS was 48.67 vs. 44.03 (P < 0.001); mean MCS was 52.80 vs. 51.23 (P = 0.203); 40% (70/175) vs. 28.3% (70/247) of women had resumed sexual intercourse (OR 1.69; 95%CI 1.12-2.54) and 21.4% (15/70) vs. 28.6% (20/70) had dyspareunia (OR 0.68; 95%CI 0.32-1.47). No differences were found at six months after birth.
One day and six weeks after birth, outcomes were better in women who had vacuum extraction. At six months, outcomes were similar. To promote quick recovery, vacuum extraction should be the first intervention considered in the second stage of labour.
评估在撒哈拉以南非洲的一家三级转诊医院中，接受真空吸引或第二产程剖宫产术（SSCS）的女性的看法。
这是一项前瞻性队列研究，对 2014 年 11 月 25 日至 2015 年 7 月 8 日期间在乌干达穆拉戈医院分娩头位、经真空吸引（n=289）或 SSCS（n=357）的足月单胎女性进行了为期 6 个月的随访。排除标准为：真空吸引失败、严重分娩并发症和婴儿死亡的女性。结局指标包括分娩体验满意度、SF-12 生活质量问卷的身体成分综合评分（PCS）和精神成分综合评分（MCS）、疼痛评分和性交困难。
在真空吸引后 1 天，63.7%（181/284）的女性感觉良好，而在 SSCS 后为 48.1%（167/347）（OR 1.89；95%CI 1.37-2.61），平均疼痛评分分别为 2.70 和 3.87（P<0.001）。在这两组中，>90%的女性对分娩体验感到满意。在 6 周时，与 SSCS 相比，真空吸引组的平均疼痛评分分别为 0.40 和 0.89（P<0.001）；平均 PCS 分别为 48.67 和 44.03（P<0.001）；平均 MCS 分别为 52.80 和 51.23（P=0.203）；40%（70/175）和 28.3%（70/247）的女性恢复了性生活（OR 1.69；95%CI 1.12-2.54），21.4%（15/70）和 28.6%（20/70）的女性出现性交困难（OR 0.68；95%CI 0.32-1.47）。产后 6 个月时未发现差异。
产后 1 天和 6 周时，接受真空吸引的女性结局更好。在 6 个月时，结局相似。为了促进快速康复，在第二产程中，应首先考虑真空吸引作为干预措施。
