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宫颈扩张晚期入院产妇的分娩结局。

Outcome of labor among women admitted at advanced cervical dilatation.

作者信息

Nkwabong Elie, Njemba Medou Jean Marc, Fomulu Joseph Nelson

机构信息

Department of Obstetrics & Gynecology, Faculty of Medicine and Biomedical Sciences, University Teaching Hospital, Yaoundé, Cameroon.

Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon.

出版信息

J Matern Fetal Neonatal Med. 2020 Jan;33(2):297-302. doi: 10.1080/14767058.2018.1489793. Epub 2018 Jul 22.

Abstract

To identify in our setting the outcome of labor among women admitted at advanced cervical dilatation. This prospective cohort study was carried out between 1 December 2015 and 31 March 2016. Women carrying live term singletons in vertex presentation admitted with a cervical dilatation >5 cm (late arrival group) or ≤5 cm (early arrival group) were followed up till delivery. The main variables studied included mode of delivery, genital lacerations, and postpartum hemorrhage (PPH). Data from women in both groups were compared. Fisher's exact test and t-test were used for comparison.  < .05 was considered statistically significant. Late arrival in the labor ward was observed in 52.5% of women (126/240). Late arrival in the labor ward was significantly associated with a reduction in the cesarean section (CS) risk (Relative risk (RR) 0.34, 95%CI 0.12-0.94), but with an increased risk of lower genital tract lacerations (RR 2.3, 95%CI 1.3-3.8), PPH (RR 4.5, 95%CI 1.04-20.2), and admission of the newborn in the neonatal intensive care unit for neonatal asphyxia or infection (RR 3.6, 95%CI 1.04-12.5). Late arrival in the labor ward was associated with an increased risk of maternal and neonatal morbidity. Therefore, women should be encouraged to arrive early in the labor ward.

摘要

为了明确我院晚期宫颈扩张产妇的分娩结局。本前瞻性队列研究于2015年12月1日至2016年3月31日进行。宫颈扩张>5cm(晚到组)或≤5cm(早到组)的单胎足月活产头先露产妇被随访至分娩。研究的主要变量包括分娩方式、生殖道裂伤和产后出血(PPH)。对两组产妇的数据进行比较。采用Fisher精确检验和t检验进行比较。P<0.05被认为具有统计学意义。52.5%(126/240)的产妇在产程晚期到达产房。产程晚期到达产房与剖宫产(CS)风险降低显著相关(相对风险(RR)0.34,95%可信区间0.12 - 0.94),但与下生殖道裂伤风险增加(RR 2.3,95%可信区间1.3 - 3.8)、PPH(RR 4.5,95%可信区间1.04 - 20.2)以及新生儿因窒息或感染入住新生儿重症监护病房的风险增加(RR 3.6,95%可信区间1.04 - 12.5)相关。产程晚期到达产房与母婴发病率增加相关。因此,应鼓励产妇尽早到达产房。

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