Fundación Universitaria Sanitas, Bogotá (Colombia)..
Rev Colomb Obstet Ginecol. 2022 Dec 30;73(4):358-368. doi: 10.18597/rcog.3878.
To assess the frequency of instrumented delivery in Colombia and by regions between 2015 and 2019.
Cross-sectional study based on population registries. Records of women with a gestational age of more than 28 weeks and vaginal delivery were included. Consecutive sampling was used. The information was taken from live birth certificates of the National Administrative Department of Statistics (DANE). Sociodemographic and clinical variables were described. The frequency of instrumented deliveries was calculated and described by year and by department.
Overall, 3,224,218 live birth records were included. Of these 1,719,405 (53.33 %) were vaginal deliveries and 1,468,726 (45.55 %) were cesarean births. At a national level, the frequency of instrumented deliveries between 2015 and 2019 was 36,087 births (1.11 %); Antioquia and Bogotá, D.C. were the places with the highest occurrence, with 16,201 (4.5 %) and 13,686 (2.52 %), respectively.
The occurrence of instrumented vaginal delivery in Colombia is the lowest and tends to diminish. Training of healthcare professionals in this approach during labor must not be abandoned, particularly in Obstetrics and Gynecology training programs. Further studies should be conducted to determine whether the increased adequate use of this technique could contribute to a lower rate of cesarean sections, and also to describe the clinical setting in which its use is safe for both the mother and the fetus. Prospective studies are required to identify the causes leading to the lower use of this obstetric tool as well as the risks and benefits in terms of maternal and perinatal outcomes.
评估 2015 年至 2019 年期间哥伦比亚各地区器械分娩的频率。
基于人群登记的横断面研究。纳入记录了妊娠 28 周以上且经阴道分娩的女性的病历。采用连续抽样法。信息取自国家行政统计部(DANE)的活产证明。对社会人口统计学和临床变量进行了描述。按年和部门计算并描述器械分娩的频率。
共纳入 3224218 例活产记录。其中 1719405 例(53.33%)为阴道分娩,1468726 例(45.55%)为剖宫产。在全国范围内,2015 年至 2019 年器械分娩的频率为 36087 例(1.11%);安蒂奥基亚和波哥大特区的发生率最高,分别为 16201 例(4.5%)和 13686 例(2.52%)。
哥伦比亚器械性阴道分娩的发生率较低且呈下降趋势。在分娩过程中,医护人员必须继续接受这种方法的培训,特别是在妇产科培训项目中。应进一步开展研究,以确定增加适当使用这种技术是否有助于降低剖宫产率,并描述安全使用这种技术的临床环境,确保母婴安全。需要开展前瞻性研究,以确定导致这种产科工具使用减少的原因,以及从母婴围产结局的角度来看,使用该工具的风险和获益。