Department of Obstetrics and Gynaecology, Faculty of Health Science, School of Clinical Medicine, University of the Witwatersrand, Johannesburg 2000, South Africa.
Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg 2000, South Africa.
Int J Environ Res Public Health. 2022 Dec 3;19(23):16182. doi: 10.3390/ijerph192316182.
Operative Vaginal delivery (OVD) can reduce perinatal and maternal morbidity and mortality especially in low resource setting such as South Africa. We evaluated the trends and determinants of OVD rates using join point regression at Charlotte Maxeke Johannesburg (CMJAH) and Chris Hani Baragwaneth (CHBAH) Academic Hospitals from 1 January 2005−31 December 2019 and conducted a comparative study of OVD (n = 179) and normal delivery (n = 179). Over the 15-year study period (2005−2019), 323,617 deliveries and 4391 OVDs were conducted at CHBAH giving an OVD rate of 1.36 per 100 births. In CMJAH, 74,485 deliveries and 1191 OVDs were conducted over an eleven-year period (2009−2019) with OVD rate of 1.60 per 100 births. OVD rate at CHBAH increased from 2005−2014 at 9.1% per annum and declined by 13.6% from 2014−2019, while OVD rates fluctuates at CMJAH. Of the 179 patients who had OVD, majority (n = 166,92.74%) had vacuum. Women who had OVDs were younger than those who vaginal delivery (p-value < 0.001). The prevalence of OVDs was higher among nulliparous women (p-value < 0.001), HIV negative women (p-value = 0.021), underweight (p-value < 0.001) as compared to normal delivery. The OVD rates has dramatically reduced over the study period This study heightens the need to further evaluate barriers to OVD use in our environment
经阴道分娩（OVD）可降低围产期和孕产妇发病率和死亡率，尤其是在南非等资源匮乏的环境中。我们使用 Joinpoint 回归分析了 2005 年 1 月 1 日至 2019 年 12 月 31 日期间在夏洛特·马克斯凯 Johannesburg（CMJAH）和 Chris Hani Baragwaneth（CHBAH）学术医院的 OVD 率的趋势和决定因素，并对 OVD（n=179）和正常分娩（n=179）进行了比较研究。在 15 年的研究期间（2005-2019 年），CHBAH 共进行了 323617 次分娩和 4391 次 OVD，OVD 率为每 100 次分娩 1.36 次。在 CMJAH，在 11 年期间（2009-2019 年）进行了 74485 次分娩和 1191 次 OVD，OVD 率为每 100 次分娩 1.60 次。CHBAH 的 OVD 率从 2005 年至 2014 年每年增长 9.1%，从 2014 年至 2019 年下降 13.6%，而 CMJAH 的 OVD 率波动。在 179 名接受 OVD 的患者中，大多数（n=166，92.74%）使用了真空。接受 OVD 的妇女比阴道分娩的妇女更年轻（p 值<0.001）。OVD 产妇中初产妇比例较高（p 值<0.001），HIV 阴性妇女（p 值=0.021），体重不足（p 值<0.001），与正常分娩相比。在研究期间，OVD 率大幅下降。这项研究强调需要进一步评估我们环境中使用 OVD 的障碍。
