Urgency of caesarean section: a new classification
Urgency of caesarean section: a new classification
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DOI：
10.1177/014107680009300703
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发表时间：
2000-07-01
影响因子：
17.3
通讯作者：
Robinson, PN
中科院分区：
文献类型：
--
作者：
Lucas, DN;Yentis, SM;Robinson, PN
在六家医院进行的一项两部分研究中，开发了一种新的剖腹产分类。最初，90名麻醉师和产科医生根据五种不同的分类方法对10种临床情况进行了分级视觉模拟量表;合适的麻醉技术;最长分娩时间;临床定义;以及1-5级评分量表。临床定义是最一致和有用的，这种方法，然后前瞻性地应用于407剖腹产在相同的六家医院。有密切的协议（86%）之间的麻醉师和产科医生的五点量表（加权kappa 0.89），如果将两个类别合并，则增加至90%（加权kappa 0.91），我们建议由此产生的四级分类系统-（i）对妇女或胎儿生命的直接威胁;（ii）不立即危及生命的母体或胎儿损害;（iii）需要提早分娩，但不会危及产妇或胎儿;（iv）在适合病人和产科团队的时间进行-应该由对产妇数据收集感兴趣的多学科小组采用。
A new classification for caesarean section was developed in a two-part study conducted at six hospitals. Initially, 90 anaesthetists and obstetricians graded ten clinical scenarios according to five different classification methods-visual analogue scale; suitable anaesthetic technique; maximum time to delivery; clinical definitions; and a 1-5 rating scale. Clinical definitions was the most consistent and useful, and this method was then applied prospectively to 407 caesarean sections at the same six hospitals. There was close agreement (86%) between anaesthetists and obstetricians for the five-point scale (weighted kappa 0.89), increasing to 90% if two categories were combined (weighted kappa 0.91),We suggest that the resultant four-grade classification system-(i) immediate threat to life of woman or fetus; (ii) maternal or fetal compromise which is not immediately life-threatening; (iii) needing early delivery but no maternal or fetal compromise; (iv) at a time to suit the patient and maternity team-should be adopted by multidisciplinary groups with an interest in maternity data collection.