Lazo-Porras Maria, Bayer Angela M, Acuña-Villaorduña Ana, Zeballos-Palacios Claudia, Cardenas-Montero Deborah, Reyes-Diaz Michael, Naranjo-Caceres Monica, Malaga German
Unidad de Conocimiento y Evidencia, Universidad Peruana Cayetano Heredia, Lima, Peru (MLP, AAV, CZP, DCM, MRD, GM).
Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru (AMB).
MDM Policy Pract. 2017 Aug 8;2(2):2381468317724409. doi: 10.1177/2381468317724409. eCollection 2017 Jul-Dec.
Explore the perspectives, decision-making process, and final mode of delivery among pregnant women with a previous C-section (Cesarean section) in a general public sector hospital in Lima, Peru. A qualitative prospective study using semistructured interviews at two time points in the outpatient obstetrics and gynecology clinic of a public sector, university-affiliated reference hospital in Lima, Peru. Seventeen adult pregnant women with a prior C-section who were deemed by their attending obstetrician to be candidates for a trial of labor were interviewed. The first interview was between 37 and 38 weeks of pregnancy, and the second interview was 24 to 48 hours after delivery.
Predelivery decision-making process and final mode of delivery. Among the 17 participants, about half (9) of the participants stated that the physician explained that they had two approaches for delivery, a trial of labor after C-section (TOLAC) or elective repeated C-section (ERCD). Two women stated that their respective providers explained only one option, either an ERCD or TOLAC. However, 6 women did not receive any information from their providers about their delivery options. Of the 10 participants that decided TOLAC, 8 ended up having a C-section, and of the 7 patients that had planned an ERCD, 1 ended up having a vaginal delivery. Many participants affirmed that they made the decision about their approach of delivery. However, most of the participants that decided a TOLAC ended up having a C-section because of complications during the final weeks of pregnancy or during labor.
在秘鲁利马的一家公立医院，探讨有剖宫产史的孕妇的观点、决策过程及最终分娩方式。这是一项定性前瞻性研究，在秘鲁利马一所大学附属的公立参考医院的妇产科门诊，于两个时间点进行半结构式访谈。对17名有剖宫产史且被主治产科医生认为适合进行试产的成年孕妇进行了访谈。第一次访谈在妊娠37至38周时进行，第二次访谈在分娩后24至48小时进行。
分娩前决策过程及最终分娩方式。在17名参与者中，约一半（9名）参与者表示医生解释了她们有两种分娩方式，即剖宫产术后试产（TOLAC）或择期再次剖宫产（ERCD）。两名女性表示她们各自的医护人员只解释了一种选择，要么是ERCD，要么是TOLAC。然而，6名女性未从医护人员那里得到关于她们分娩选择的任何信息。在决定进行TOLAC的10名参与者中，8人最终进行了剖宫产，在计划进行ERCD的7名患者中，1人最终进行了阴道分娩。许多参与者肯定她们对自己的分娩方式做出了决定。然而，大多数决定进行TOLAC的参与者最终进行了剖宫产，原因是在妊娠最后几周或分娩期间出现了并发症。
