Lukasse Mirjam, Hovda Ingrid, Thommessen Sara, McAuley Sosan, Morrison Marian
Institute of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
Department of Nursing and Health Sciences, Faculty of Health and Social Sciences,University of South-Eastern Norway, Borre, Norway.
Eur J Midwifery. 2020 Aug 6;4:33. doi: 10.18332/ejm/124111. eCollection 2020.
One of the most common complications during labor is prolonged labor (dystocia), which is associated with risks for the mother and fetus. Dystocia is usually treated with oxytocin, which is also used to induce labor. Oxytocin may not have the desired effect of progress and can negatively affect the fetus, thus resulting in an emergency caesarean section (CS). The aim of this study was to describe obstetric practice, use of oxytocin and its association with an emergency CS.
A cross-sectional retrospective register study was conducted that included all women who gave birth during 2014 and 2015 at a hospital in a large city in Pakistan.
A total of 6652 women gave birth to 6767 newborns, 66.8% were multiparous and 33.2% primiparous women. Of the primiparous women, 78.9% had a spontaneous vaginal birth, 1.2% an elective CS and 14.4% an emergency CS. Of the multiparous women, 81.9% had a spontaneous vaginal birth, 8.0% an elective CS and 6.7% an emergency CS. Operative vaginal birth was 2.1% among primiparous and 0.2% among multiparous women. Oxytocin for induction or augmentation was administered to 60.0% of primiparous and 30.5% of multiparous women. Oxytocin during the first stage of labor was associated with an increased risk for emergency CS for both primiparous and multiparous women.
Despite the association between oxytocin and emergency CS, the CS rate was low in this hospital. The majority of the women gave birth vaginally, even with a breech presentation. Few operative vaginal births were performed.
分娩过程中最常见的并发症之一是产程延长（难产），这对母亲和胎儿都有风险。难产通常用缩宫素治疗，缩宫素也用于引产。缩宫素可能无法达到预期的促进产程进展的效果，并且可能对胎儿产生负面影响，从而导致紧急剖宫产（CS）。本研究的目的是描述产科实践、缩宫素的使用及其与紧急剖宫产的关联。
进行了一项横断面回顾性登记研究，纳入了2014年和2015年在巴基斯坦一个大城市的一家医院分娩的所有妇女。
共有6652名妇女分娩了6767名新生儿，66.8%为经产妇，33.2%为初产妇。在初产妇中，78.9%为自然阴道分娩，1.2%为选择性剖宫产，14.4%为紧急剖宫产。在经产妇中，81.9%为自然阴道分娩，8.0%为选择性剖宫产，6.7%为紧急剖宫产。初产妇中手术助产率为2.1%，经产妇中为0.2%。60.0%的初产妇和30.5%的经产妇使用了缩宫素进行引产或加强宫缩。初产妇和经产妇在第一产程使用缩宫素均与紧急剖宫产风险增加有关。
尽管缩宫素与紧急剖宫产有关联，但该医院的剖宫产率较低。大多数妇女经阴道分娩，即使是臀位。进行的手术助产很少。
