尼日利亚拉各斯大学教学医院（2002-2017 年）器械性阴道分娩和剖宫产术的接产点趋势。

Join point trends of instrumental vaginal deliveries and cesarean sections at the Lagos University Teaching Hospital, Lagos, Nigeria (2002-2017).

机构信息

Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, LUTH, Lagos, Nigeria.

College of Medicine, University of Lagos, Lagos, Nigeria.

出版信息

Int J Gynaecol Obstet. 2024 Oct;167(1):445-452. doi: 10.1002/ijgo.15707. Epub 2024 Jun 12.

DOI:10.1002/ijgo.15707

PMID:38864274

Abstract

OBJECTIVE

To determine the trends of instrumental vaginal delivery (IVD) and cesarean section (CS) at the Lagos University Teaching Hospital (LUTH), Nigeria, over 16 years, from 2002 to 2017.

METHODS

A retrospective cross-sectional study. The case records of all women who had IVD and CS during the study period were reviewed. The trends in the IVD and CS rates were evaluated using join point regression modeling. The average annual percent change (AAPC) and annual percent change (APC) with associated 95% confidence interval of segmental trends were calculated.

RESULTS

The overall IVD rate was 1.36%. Vacuum delivery rate was higher than forceps (0.79% vs 0.57%). The CS rate was 44.9 per 100 deliveries; the rate increased by about 3.7% per annum. CS rates were 7.1-89.9 times the IVD rates within the study period. The number of IVDs performed in the hospital declined by about 83.02%, from 53 cases in 2002 to nine cases in 2017. Forceps delivery declined at a faster rate than vacuum delivery between 2002 and 2017 (AAPC for forceps: -12.6% [-17.5 to -7.5], P < 0.001 vs AAPC for vacuum: -6.2% [-14.3 to 2.7], P = 0.200). The commonest indication for IVD was prolonged second stage of labor (47/162, 29.01%) and shortening of the second stage of labor for maternal conditions (47/162, 29.01%).

CONCLUSION

IVD rates are low and declining at LUTH. There is need to train accoucheurs on the safe use of IVDs to potentially reduce the CS rate.

摘要

目的

在 2002 年至 2017 年的 16 年间，确定尼日利亚拉各斯大学教学医院（LUTH）的器械性阴道分娩（IVD）和剖宫产（CS）趋势。

方法

这是一项回顾性的横断面研究。回顾了研究期间所有接受 IVD 和 CS 的女性的病例记录。使用连接点回归模型评估 IVD 和 CS 率的趋势。计算了分段趋势的平均年变化百分比（AAPC）和年变化百分比（APC）及其 95%置信区间。

结果

总的 IVD 率为 1.36%。真空分娩率高于产钳（0.79% vs 0.57%）。CS 率为每 100 例分娩 44.9 例；每年增加约 3.7%。在研究期间，CS 率是 IVD 率的 7.1-89.9 倍。医院实施的 IVD 数量减少了约 83.02%，从 2002 年的 53 例降至 2017 年的 9 例。在 2002 年至 2017 年期间，产钳分娩的下降速度快于真空分娩（产钳的 AAPC：-12.6%[-17.5 至-7.5]，P<0.001 与真空的 AAPC：-6.2%[-14.3 至 2.7]，P=0.200）。IVD 的最常见指征是第二产程延长（47/162，29.01%）和缩短产妇条件下的第二产程（47/162，29.01%）。