The influence of maternal and foetal factors on the success of medically induced labour

Autor: Mirta Kadivnik, Gordana Lončar, Andrea Teodosić, Kristina Kralik, Iva Milić Vranješ, Maja Košuta Petrović
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Medicina Fluminensis : Medicina Fluminensis
Volume 57
Issue 3
ISSN: 1848-820X
1847-6864
Popis: Labour induction is the process in which labour is induced mechanically or pharmacologically. The percentage of induced labours is between 1.4% and 32% of the total number of births in the world. The aim of this research is to present the number of medically induced labours from 2012 to 2019 at the Clinic for Gynaecology and Obstetrics of the Clinical Hospital Center in Osijek and to present the success rate of medically induced labour and factors, both maternal and/or foetal which may affect it. Materials and methods: In the study 2361 subjects were included whose births were induced by medication regardless of the indication for medically induced labour, gestational age or mother’s age. χ2 test, Mann Whitney U test, Fisher’s exact test, Kruskal Wallis test (Pot Hoc Conover), and the univariate and multivariate logistic regression model were used. Results: The percentage of inductions was 13.8%. 81% of the child births was completed vaginally , while 19% was completed by the caesarean section. The univariate regression analysis found that meconium amniotic fluid increases the risk of the caesarean section after the labour has been induced. Factors decreasing the possibility of the caesarean section after induced labour include multiparity, women age between 25 and 35 years and women bearing female children. The multivariate statistical regression model found that women over the age of 36 are 1.58 times more likely to have the caesarean section. Women with meconium amniotic fluid are 1.47 times more likely to have the caesarean section. Multiparity in the mother and the female sex of the child reduce the probability of the caesarean section after induced labour (odds ratio (OR) 0.20, P=0.02 and OR 0.84, P=0.09, respectively). Conclusion: The study indicates that multiparity and female gender of child increase the probability of the vaginal birth after the induction, while the mother’s age over 36 and meconium amniotic fluid after the induction increase the risk of the caesarean section.
Indukcija poroda postupak je kojim mehaničkim ili farmakološkim putem pokušavamo potaknuti porod. Postotak induciranih porođaja u svijetu mjeri se od 1,4 do čak 32 % od ukupnog broja poroda. Cilj je ovog preglednog rada prikazati broj medikamentozno induciranih poroda u razdoblju od 2012. do 2019. godine na Klinici za ginekologiju Kliničkog bolničkog centra u Osijeku, prikazati uspješnost medikamentozne indukcije poroda te koji od materničnih i/ili fetalnih faktora mogu utjecati na uspjeh indukcije poroda. Materijali i metode: Koristili smo podatke iz rađaonskog protokola Klinike za ginekologiju i porodništvo Kliničkog bolničkog centra u Osijeku. U istraživanje smo uključili 2361 ispitanicu čiji su porodi inducirani medikamentozno. Statistički smo obradili podatke o vrsti indukcije poroda, indikacijama za indukciju poroda te načinu poroda nakon indukcije. Koristili smo χ2 test, Mann Whitney U test, Fisherov egzaktni test, Kruskal Wallis test (Pot Hoc Conover) te model univarijantne i multivarijantne logističke regresije. Rezultati: Postotak indukcija bio je 13,8 %. U 81 % slučajeva porod je dovršen vaginalnim putem, dok je u 19 % slučajeva dovršen carskim rezom. Utvrdili smo da je čimbenik rizika za carski rez nakon indukcije poroda dijagnoza mekonijske plodove vode, dok su čimbenici koji smanjuju vjerojatnost carskog reza – dob majke od 25 do 35 godina, trudnice koje su rodile žensko dijete te trudnice koje su do sada već rađale. Modelom multivarijantne statističke regresije utvrdilo se da žene u dobi iznad 36 godina imaju 1,58 puta veću šansu za carski rez u odnosu na mlađe, a one s prisutnom dijagnozom mekonijske plodove vode 1,47 puta veću šansu za carski rez u odnosu na one koje nemaju navedenu dijagnozu. Multiparitet u majke te ženski spol djeteta smanjuju vjerojatnost carskog reza nakon indukcije poroda (redom OR 0.20, P = 0.02 te OR 0.84, P = 0.09). Zaključak: Studija je pokazala da su multiparitet i ženski spol djeteta protektivni faktori za vaginalni porod, dok su dob majke iznad 36 godina te zelena plodna voda nakon indukcije poroda rizični faktori za carski rez.
Databáze: OpenAIRE
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