Tadesse Workinesh Ketema, Bekele Nardos Tilahun, Negussie Yohannes Mekuria, Getahun Mihiret Shawel, Gurara Abenet Menene, Beyen Teresa Kisi
Department of Nursing, Adama General Hospital and Medical College, Adama, Ethiopia.
Department of Public Health, Adama Hospital Medical College, Adama, Ethiopia.
SAGE Open Nurs. 2023 Jun 12;9:23779608231180382. doi: 10.1177/23779608231180382. eCollection 2023 Jan-Dec.
Operative vaginal deliveries are a method of dealing with issues that arise during the second stage of labor with the use of vacuum device or forceps. The decision to use an instrument to deliver the fetus weighs the maternal, fetal, and neonatal consequences of the procedure against the alternative option of cesarean birth. However, evidence on operative vaginal delivery is limited in Ethiopia in general and in the study area in particular.
This study aimed to assess the magnitude, indications, and factors associated with operative vaginal delivery among mothers who gave birth at Adama Hospital Medical College, Ethiopia.
A facility-based cross-sectional study was conducted among a sample of 440 mothers who gave birth from 1 to 30 June 2022. A systematic random sampling technique was used to select the study participants. Data were collected using an interviewer-administered structured questionnaire. The data were entered into EPI INFO version 7 and exported to SPSS version 25 for analysis. Bivariate logistic regression analysis was used to identify candidate variables at < .25 and multivariable logistic regression analysis was used to identify the independent predictors of operative vaginal delivery at < .05 with 95% confidence intervals (CIs).
The magnitude of operative vaginal delivery was 14.8% (95% CI: 10.8, 18.8). Rural residence (adjusted odds ratio (AOR), 2.09; 95% CI: 2.01, 7.41), maternal age 25-34 (AOR, 4.95; 95% CI: 1.62, 9.2), being primigravida (AOR: 3.5, 95% CI: 1.26, 9.98), gestational age ≥42 weeks (3.09; 95% CI: 1.38, 6.9), and antenatal care (ANC) follow-ups <4 times (AOR:3.9; 95% CI: 1.09, 9.45) were significantly associated with operative vaginal delivery.
The magnitude of operative vaginal delivery in the study area was relatively low. Rural residence, maternal age 25 to 34, primigravida, gestational age ≥42 weeks, and ANC follow-ups <4 times were independent determinants of operative vaginal delivery. Thus, health education programs and other multidisciplinary strategies are required to encourage mothers to have regular ANC follow-ups.
手术助产是一种在第二产程中使用真空吸引器或产钳处理相关问题的方法。决定使用器械助产时，需要权衡该操作对母体、胎儿和新生儿的影响与剖宫产这一替代选择。然而，在埃塞俄比亚，总体而言，关于手术助产的证据有限，在研究区域尤其如此。
本研究旨在评估埃塞俄比亚阿达马医院医学院分娩的母亲中手术助产的发生率、指征及相关因素。
对2022年6月1日至30日分娩的440名母亲进行了一项基于机构的横断面研究。采用系统随机抽样技术选取研究对象。通过访谈员 administered 的结构化问卷收集数据。数据录入 EPI INFO 7版本并导出至SPSS 25版本进行分析。二元逻辑回归分析用于在<0.25时识别候选变量，多变量逻辑回归分析用于在<0.05且95%置信区间（CI）的情况下识别手术助产的独立预测因素。
手术助产的发生率为14.8%（95%CI：10.8，18.8）。农村居住（调整比值比（AOR），2.09；95%CI：2.01，7.41）、母亲年龄25 - 34岁（AOR，4.95；95%CI：1.62，9.2）、初产妇（AOR：3.5，95%CI：1.26，9.98）、孕周≥42周（3.09；95%CI：1.38，6.9）以及产前检查（ANC）次数<4次（AOR：3.9；95%CI：1.09，9.45）与手术助产显著相关。
研究区域手术助产的发生率相对较低。农村居住、母亲年龄25至34岁、初产妇、孕周≥42周以及产前检查次数<4次是手术助产的独立决定因素。因此，需要开展健康教育项目及其他多学科策略，鼓励母亲定期进行产前检查。
