Non-elective caesarean delivery due to ineffective uterine contractility or due to obstructed labour in relation to maternal body mass index
Non-elective caesarean delivery due to ineffective uterine contractility or due to obstructed labour in relation to maternal body mass index
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DOI：
10.1016/j.ejogrb.2009.05.022
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发表时间：
2009-08-01
影响因子：
2.6
通讯作者：
Cedergren, Marie I.
中科院分区：
文献类型：
--
作者：
Cedergren, Marie I.
目的：评估因难产和/或子宫收缩力无效而进行的非选择性剖腹产是否与母体体重指数（BMI）相关。来自瑞典医学出生登记处的前瞻性数据集包括233，887名未经产的自发分娩的妇女，这些妇女被归类为6类孕前BMI，她们在2011年1月1日至2012年1月1日期间在瑞典分娩。1999年和2005年12月31日。分娩方式分为阴道分娩或剖腹产。剖腹产分为选择性或非选择性。调整后的风险，非择期剖腹产由于无效的子宫收缩，或难产或胎儿窘迫使用Mantel-Haenszel technique. Results：非择期剖腹产的风险，由于梗阻约是没有显着相关的母亲体重指数。然而，无效的子宫收缩力与母体BMI显著相关，并且由于分娩停滞障碍而导致的非选择性剖腹产的风险随着BMI的增加而增加，在病态肥胖女性中风险增加4倍。由于胎儿窘迫的非择期剖腹产的风险也显着增加与产妇BMI.Conclusions：看来无效劳动可能是一个因素，导致肥胖和病态肥胖妇女的非择期剖腹产的风险增加。这些发现挑战产科医生学习更多关于如何管理催产素输注在分娩过程中与产妇体重指数。(C)2009爱思唯尔爱尔兰有限公司保留所有权利。
Objective: To assess whether non-elective caesarean section due to obstructed labour and/or ineffective uterine contractility was associated with maternal body mass index (BMI).Study design: The prospective dataset from the Swedish Medical Birth Registry consisted of 233,887 nulliparous women with a spontaneous onset of labour categorized in six classes of pre-pregnancy BMI, who delivered in Sweden between, January 1, 1999 and December 31, 2005. The mode of delivery was classified as either vaginal or by caesarean section. The caesarean section was classified as either elective or non-elective. Adjusted risks for non-elective caesarean section due to ineffective uterine contractility, or obstructed labour or fetal distress were determined using Mantel-Haenszel technique.Results: The risk of a non-elective caesarean section due to obstructed about was not significantly associated with maternal BMI. However, ineffective uterine contractility was significantly associated with maternal BMI and the risk of non-elective caesarean delivery due to labour arrest disorders increased with increasing BMI, reaching a 4-fold increased risk among the morbidly obese women. The risk of non-elective caesarean section due to fetal distress also increased significantly with increasing maternal BMI.Conclusions: It appears that ineffective labour could be a factor leading to the increased risk of non-elective caesarean section among obese and morbidly obese women. These findings challenge obstetricians to learn more about how to manage oxytocin infusions during labour in relation to maternal BMI. (C) 2009 Elsevier Ireland Ltd. All rights reserved.