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. 2019 May;24(5):553-562. doi: 10.1111/tmi.13222. Epub 2019 Mar 27.
To investigate what women who have experienced vacuum extraction or second stage caesarean section (CS) would recommend as mode of birth in case of prolonged second stage of labour.
A prospective cohort study was conducted in a tertiary referral hospital in Uganda. Between November 2014 and July 2015, women with a term singleton in vertex presentation who had undergone vacuum extraction or second stage CS were included. The first day and 6 months after birth women were asked what they would recommend to a friend: vacuum extraction or CS and why. Outcome measures were: proportions of women choosing vacuum extraction vs. CS and reasons for choosing this mode of birth.
The first day after birth, 293/318 (92.1%) women who had undergone vacuum extraction and 176/409 (43.0%) women who had undergone CS recommended vacuum extraction. Of women who had given birth by CS in a previous pregnancy and had vacuum extraction this time, 31/32 (96.9%) recommended vacuum extraction. Six months after birth findings were comparable. Less pain, shorter recovery period, avoiding surgery and the presumed relative safety of vacuum extraction to the mother were the main reasons for preferring vacuum extraction. Main reasons to opt for CS were having experienced CS without problems, CS presumed as being safer for the neonate, CS being the only option the woman was aware of, as well as the concern that vacuum extraction would fail.
Most women would recommend vacuum extraction over CS in case of prolonged second stage of labour.
调查经历过真空吸引或第二产程剖宫产的女性，如果第二产程延长，会推荐哪种分娩方式。
这是乌干达一家三级转诊医院进行的前瞻性队列研究。2014 年 11 月至 2015 年 7 月期间，纳入足月单胎头位、行真空吸引或第二产程剖宫产的女性。分娩后第 1 天和第 6 个月，询问每位女性会向朋友推荐哪种分娩方式：真空吸引还是剖宫产，以及原因。主要结局指标为：选择真空吸引与剖宫产的女性比例，以及选择这种分娩方式的原因。
分娩后第 1 天，293/318（92.1%）例行真空吸引的女性和 176/409（43.0%）例行第二产程剖宫产的女性推荐真空吸引。在先前剖宫产、本次行真空吸引的女性中，32/32（96.9%）推荐真空吸引。产后 6 个月的发现结果相似。推荐真空吸引的主要原因是疼痛较轻、恢复时间较短、避免手术以及相对安全。选择剖宫产的主要原因是无剖宫产相关问题、认为对新生儿更安全、女性只知道剖宫产、担心真空吸引失败。
大多数女性如果第二产程延长，会推荐真空吸引而非剖宫产。
