真空负压助产中胎头枕后位增加肛门括约肌损伤风险
Occiput posterior fetal head position increases the risk of anal sphincter injury in vacuum-assisted deliveries作者机构：Department of Obstetrics and Gynecology University of North Carolina at Chapel Hill Chapel Hill NC United States Dr
出 版 物：《世界核心医学期刊文摘（妇产科学分册）》 (Core Journal in Obstetrics/Gynecology)
年 卷 期：2005年第1卷第12期
页 面：18-18页
学科分类：1011[医学-护理学（可授医学、理学学位）] 10[医学]
主 题：枕后位 括约肌损伤 真空负压 胎头位置 外阴切开术 第二产程 单胎妊娠 枕前位 会阴撕裂 产科学
摘 要：Objective: The purpose of this study was to determine whether an occiput posterior (OP) fetal head position increases the risk for anal sphincter injury when compared with an occiput anterior (OA) position in vacuum-assisted deliveries. Study design: We conducted a retrospective cohort study of 393 vacuum-assisted singleton vaginal deliveries. Maternal demographics and obstetric and neonatal data were collected from an obstetric database and chart review. Results: Within the OP group, 41.7% developed a third -or fourth-degree laceration compared with 22.0% in the OA group (OR 2.5, 95% CI 1.4- 4.7). In a logistic regression model that controlled for BMI, race, nulliparity, length of second stage, episiotomy, birth weight, head circumference, and fetal head position, OP position was 4.0 times (95% CI 1.7- 9.6) more likely to be associated with an anal sphincter injury than OA position. Conclusion: Among vacuum deliveries, an OP head position confers an incrementally increased risk for anal sphincter injury over an OA position.
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