Occipitoposterior position: associated factors and obstetric outcome in nulliparas
| Autor: | A R Sizer, D M Nirmal |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent medicine.medical_treatment Birth weight Population Labor Presentation Pregnancy Risk Factors medicine Odds Ratio Birth Weight Humans education Retrospective Studies education.field_of_study Obstetrics business.industry Incidence Infant Newborn Obstetrics and Gynecology Retrospective cohort study Odds ratio medicine.disease Delivery Obstetric United Kingdom Obstetric Labor Complications Parity Logistic Models Labor induction Anesthesia Apgar Score Gestation Apgar score Female business |
| Zdroj: | Obstetrics and gynecology. 96(5 Pt 1) |
| ISSN: | 0029-7844 |
| Popis: | Objective: To determine factors associated with term delivery in the occipitoposterior position and examine obstetric outcomes from that delivery position in nulliparas. Methods: We did a retrospective analysis of population-based data of 16,781 nulliparas who delivered at term (37–42 weeks) with singleton, cephalic presentations. Factors examined for possible association with occipitoposterior position were fetal weight, maternal age, completed weeks of gestation, epidural analgesia in labor, labor induction, and oxytocin augmentation. Obstetric outcome measures were mode of delivery and percentage of infants with Apgar scores less than 8 at 5 minutes. Results: The frequency of occipitoposterior position was 4.6%. Fetal weight, epidural analgesia, and oxytocin augmentation were strongly associated with delivery in the occipitoposterior position (odds ratios 1.18, 2.21, 1.44, respectively, P < .001, logistic regression). There was a higher incidence of instrument and emergency cesarean deliveries in occipitoposterior compared with occipitoanterior labors (43.7% versus 24.4%, 41.7% versus 13.7%, respectively, P < .001, the χ2 test). There was no significant difference in percentage of infants with low Apgar scores at 5 minutes between those who delivered occipitoposterior or occipitoanterior. Conclusion: Epidural analgesia and oxytocin augmentation are associated with increased incidence of occipitoposterior position, which leads to increased operative obstetric intervention for delivery. |
| Databáze: | OpenAIRE |
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