Shimalis Chaltu, Hasen Tahir, Regasa Misganu Teshoma, Desalegn Zelalem, Mulisa Diriba, Upashe Shivaleela P
Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Oromia, Ethiopia.
Department of Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Oromia, Ethiopia.
SAGE Open Med. 2022 Jul 22;10:20503121221113091. doi: 10.1177/20503121221113091. eCollection 2022.
In developing countries like Ethiopia, there is lack of evidence that shows the magnitude and factors affecting complications of instrumental delivery. Most of the research done in Ethiopia was secondary data and lacks variables like socio-demographic factors, availability of cardiotocograph, number of traction, and who conducted delivery (qualification of health workers). So, this study tried to fill the gaps by conducting primary research with secondary data and adding those variables stated above.
Health facility-based cross-sectional study was conducted from 20 February 20 June 2020 in five public hospitals in East Wollega Zone. Single population proportion formula used to calculate sample size. Systematic random sampling was employed. Interviewer-administered structured questionnaire, checklist, and document review were used to collect data from 282 respondents. Data entered to Epi Data version 3.01 and exported to a statistical package of social sciences version 21 for analysis. Those variables with < 0.25 in the bivariate analyses were a candidate for multivariable logistic regression and multivariable logistic regression was done to identify factors associated with complications of instrumental vaginal delivery using 95% confidence interval and < 0.05.
Complications of instrumental vaginal delivery were 37.2%. Out of all neonates delivered by operative vaginal delivery, 69 (24.5%) developed complications. Vacuum-assisted delivery (adjusted odd ratio = 0.245, 95% confidence interval 0.092-0.658), 120-160 fetal heartbeats per minute (adjusted odd ratio = 0.298, 95% confidence interval 0.114-0.628), birthweight > 4000 g (adjusted odd ratio = 4.09, 95% confidence interval 1.729-9.499) and outlet instrumentation (adjusted odd ratio = 0.139, 95% confidence interval 0.057-0.339) were associated with complications of instrumental vaginal delivery.
Magnitude of complications of instrumental vaginal delivery was high in the study area. So, health professionals should give due attention on instrument selection and application. Instrumental delivery requires a careful assessment of clinical circumstances to identify the indications and contraindications for the application of the instruments.
在埃塞俄比亚这样的发展中国家，缺乏表明器械助产并发症的严重程度及影响因素的证据。埃塞俄比亚开展的大多数研究都是二手数据，缺乏社会人口学因素、胎心监护仪的可用性、牵引次数以及助产人员（卫生工作者资质）等变量。因此，本研究试图通过开展一手研究并结合二手数据，纳入上述变量来填补这些空白。
2020年2月20日至6月20日在东沃莱加地区的五家公立医院开展了基于医疗机构的横断面研究。使用单总体比例公式计算样本量。采用系统随机抽样。通过访谈员实施的结构化问卷、检查表和文件审查，从282名受访者处收集数据。数据录入Epi Data 3.01版本，并导出到社会科学统计软件包21版本进行分析。双变量分析中比值比<0.25的变量作为多变量逻辑回归的候选变量，并进行多变量逻辑回归，以确定与器械助产阴道分娩并发症相关的因素，使用95%置信区间且P<0.05。
器械助产阴道分娩的并发症发生率为37.2%。在所有经阴道助产分娩的新生儿中，69例（24.5%）出现并发症。真空助产（调整后的比值比=0.245，95%置信区间0.092 - 0.658）、每分钟胎心120 - 160次（调整后的比值比=0.298，95%置信区间0.114 - 0.628）、出生体重>4000g（调整后的比值比=4.09，95%置信区间1.729 - 9.499）以及出口产钳助产（调整后的比值比=0.139，95%置信区间0.057 - 0.339）与器械助产阴道分娩并发症相关。
研究区域内器械助产阴道分娩的并发症发生率较高。因此，卫生专业人员应在器械选择和应用上给予应有的关注。器械助产需要仔细评估临床情况，以确定器械应用的适应证和禁忌证。
