Dystocia in labour - risk factors, management and outcome: a retrospective observational study in a Swedish setting
Dystocia in labour - risk factors, management and outcome: a retrospective observational study in a Swedish setting
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DOI：
10.1080/00016340701837744
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发表时间：
2008-01-01
影响因子：
4.3
通讯作者：
Berg, Marie
中科院分区：
文献类型：
--
作者：
Selin, Lotta;Wallin, Gunnar;Berg, Marie
背景分娩难产（LD）与不良的母婴结局相关。本研究调查了LD的产科危险因素、干预频率和分娩结局。方法. 2000年至2001年期间，在瑞典一家地区医院对1 480例分娩进行了回顾性观察研究。结果在21%的分娩中发现了LD，其中16.7%以剖腹产（CS）结束，而没有LD的分娩为1.7%。无阴道分娩史的多产（OR=6.0）、宫颈扩张时硬膜外镇痛（EDA）≥ 42周（OR=3.1）、出生体重> 4,000 g（OR=2.7）和宫颈扩张时EDA> 5 cm（OR=2.0）是LD的主要独立危险因素。结论.在分娩管理中，应特别注意初产妇和未经阴道分娩的经产妇。给予EDA的妇女，特别是宫颈扩张>= 5 cm的妇女也特别感兴趣。此外，LD诊断和催产素增强的严格程序是重要的。
Background. Labour dystocia (LD) is associated with adverse maternal and child outcomes. This study investigated obstetric risk factors, frequency of interventions and delivery outcomes for LD. Methods. A retrospective, observational, study of 1,480 deliveries was undertaken in a Swedish district hospital during 2000 and 2001. Results. LD was identified in 21% of deliveries, 16.7% of which ended in caesarean section (CS) compared to 1.7% of deliveries without LD. Multiparity with no previous vaginal delivery (OR=6.0), epidural analgesia (EDA) at cervical dilation = 42 weeks (OR=3.1), birth weight > 4,000 g (OR=2.7) and EDA at cervical dilation > 5 cm (OR=2.0) were major independent risk factors for LD. Conclusions. In delivery management, special attention should be directed to primiparous women and multiparous women with no previous vaginal delivery. Women given EDA, especially at cervical dilation >= 5 cm are also of particular interest. Furthermore, rigorous routines for LD diagnosis and oxytocin augmentation are important.