Dzemdību iznākums un sarežģījumi inducēto dzemdību pacientēm viena trešā līmeņa stacionāra dzemdību nodaļā 2023.-2024.
Loading...
Date
Authors
Advisor
Journal Title
Journal ISSN
Volume Title
Publisher
Latvijas Universitāte
Language
lav
Abstract
Ievads. Dzemdību indukcija ir medicīniska procedūra, kas Latvijā un pasaulē kļuvusi par bieži izmantotu metodi. 2023.gadā 33% dzemdībās Latvijā tika pielietota dzemdību indukcija. Paralēli DzI pielietošanas biežuma pieaugumam, sabiedrībā arvien vairāk sastopamas grūtnieces ar paaugstinātu ķermeņa masas indeksu. Tas rada nepieciešamību padziļināti pētīt iespējamo saistību starp DzI metodēm un paaugstināta ĶMI ietekmi uz dzemdību gaitu, mātes un jaundzimušā veselības iznākumiem. Darba mērķis. Izvērtēt dzemdību izraisīšanas ietekmi pacientēm ar normālu un paaugstinātu ķermeņa masas indeksu. Pētījumā salīdzināt izmantotās DzI metodes, to indikācijas un ietekmi uz māti un jaundzimušo, izvērtēt to efektivitāti un saistību ar dzemdību komplikācijām. Materiāli un metodes. Retrospektīvs pētījums laika posmā no 2023.gada janvāra līdz 2024.gada decembrim viena trešā līmeņa stacionāra dzemdību nodaļā. Iekļaušanas kritēriji: vienaugļa grūtniecība, spontānas inducētas dzemdības, dzīvs auglis. Iegūtie dati tika analizēti SPSS ver.29. Rezultāti. Pētījumā tika iekļautas 1127 pacientes, kurām pielietota dzemdību indukcija, no tām 208 bija paaugstināts ĶMI. Veiksmīga indukcija tika novērota 830 (74%) gadījumos, savukārt neveiksmīga indukcija bija 297 (26 %) gadījumos. Vidējais ĶMI veiksmīgā DzI grupā bija 25,01 (SD±5,55), savukārt otrajā grupā 26,84 (SD±6,09)(p=0,001). Vidējais pirmā un trešā dzemdību perioda ilgums bija garāks pirmdzemdētājām ar paaugstinātu ĶMI nekā pirmdzemdētājām kontroles grupā (538,67 min pret 523,09 min). Savukārt, vidējais otrā dzemdību perioda ilgums pirmdzemdētājām ar paaugstinātu ĶMI bija īsāks nekā kontroles grupā. Visbiežāk tika kombinēts misoprostols (n=372), Foley katetrs(n=331) un Amniotomija (n=356). 85 gadījumos (29%), tika novērota dzemdes disfunkcija/ atonija, kā iemesls akūtam Ķeizargriezienam. Secinājumi. Paaugstināts mātes ķermeņa masas indekss ir saistīts ar paaugstinātu risku neveiksmīgam DzI iznākumam, jaundzimušā iznākumiem, dzemdību periodiem. Dzemdību indukcijas metožu kombinācija ir biežāka. Misoprostola paaugstināta deva ir riska faktors starpenes plīsuma pakāpei, Bišopa skalas vērtējumam, paaugstinātam riskam neveiksmīgai indukcijai Atslēgas vārdi. Dzemdību indukcija, misoprostols, Foley katetrs, amniotomija, oksitocīns, spontānas dzemdības, dzemdību iznākums
Introduction. Labor induction is a medical procedure that has become increasingly common among pregnant women in Latvia and worldwide. In 2023, labor induction was used in 33% of all deliveries in the country. Alongside the rising prevalence of labor inductions, There is a growing prevalence of pregnant women with an elevated body mass index (BMI) in the population. This highlights the need for an in-depth investigation into the potential correlation between labor induction methods and the impact of elevated BMI on the course of labor and maternal and neonatal outcomes. Aim of the Study. The aim of this study is to evaluate the impact of labor induction on patients with normal and elevated body mass index. The study compares the labor induction methods used, their indications, and their effects on the mother and newborn, assessing their effectiveness and their relationship with birth complications. Materials and Methods. Retrospective study from January 2023 to December 2024 in a tertiary-level maternity department. The inclusive criteria were singleton pregnancy, spontaneous labor induction, and a live fetus. The data obtained was analyzed using SPSS version 29. Results. The study included 1,127 patients who underwent labor induction, of whom 208 had an elevated body mass index (BMI). Successful induction was observed in 830 cases (74%), while 297 cases (26%) were classified as unsuccessful. The mean BMI in the successful induction group was 25.01 (SD ±5.55), whereas in the unsuccessful group it was 26.84 (SD ±6.09) (p = 0.001). Among nulliparous women with elevated BMI, the average duration of the first and third stages of labor was longer compared to those in the control group (538.67 min vs. 523.09 min). In contrast, the average duration of the second stage of labor was shorter in nulliparous women with elevated BMI compared to the control group. The most frequently used induction methods were a combination of misoprostol (n = 372), Foley catheter (n = 331), and amniotomy (n = 356). Uterine dysfunction or atony was observed in 85 cases (29%) as a cause of emergency caesarean section. Conclusions. An elevated maternal BMI is associated with an increased risk of unsuccessful labor induction outcomes, adverse neonatal outcomes, and prolonged labor stages. The combination of LI methods is more common. A higher misoprostol dose is a risk factor for perineal tear severity, Bishop scale score, and an increased risk of failed induction.. Keywords: Labor induction, misoprostol, Foley catheter, amniotomy, oxytocin, spontaneous vaginal delivery, birth outcomes.
Introduction. Labor induction is a medical procedure that has become increasingly common among pregnant women in Latvia and worldwide. In 2023, labor induction was used in 33% of all deliveries in the country. Alongside the rising prevalence of labor inductions, There is a growing prevalence of pregnant women with an elevated body mass index (BMI) in the population. This highlights the need for an in-depth investigation into the potential correlation between labor induction methods and the impact of elevated BMI on the course of labor and maternal and neonatal outcomes. Aim of the Study. The aim of this study is to evaluate the impact of labor induction on patients with normal and elevated body mass index. The study compares the labor induction methods used, their indications, and their effects on the mother and newborn, assessing their effectiveness and their relationship with birth complications. Materials and Methods. Retrospective study from January 2023 to December 2024 in a tertiary-level maternity department. The inclusive criteria were singleton pregnancy, spontaneous labor induction, and a live fetus. The data obtained was analyzed using SPSS version 29. Results. The study included 1,127 patients who underwent labor induction, of whom 208 had an elevated body mass index (BMI). Successful induction was observed in 830 cases (74%), while 297 cases (26%) were classified as unsuccessful. The mean BMI in the successful induction group was 25.01 (SD ±5.55), whereas in the unsuccessful group it was 26.84 (SD ±6.09) (p = 0.001). Among nulliparous women with elevated BMI, the average duration of the first and third stages of labor was longer compared to those in the control group (538.67 min vs. 523.09 min). In contrast, the average duration of the second stage of labor was shorter in nulliparous women with elevated BMI compared to the control group. The most frequently used induction methods were a combination of misoprostol (n = 372), Foley catheter (n = 331), and amniotomy (n = 356). Uterine dysfunction or atony was observed in 85 cases (29%) as a cause of emergency caesarean section. Conclusions. An elevated maternal BMI is associated with an increased risk of unsuccessful labor induction outcomes, adverse neonatal outcomes, and prolonged labor stages. The combination of LI methods is more common. A higher misoprostol dose is a risk factor for perineal tear severity, Bishop scale score, and an increased risk of failed induction.. Keywords: Labor induction, misoprostol, Foley catheter, amniotomy, oxytocin, spontaneous vaginal delivery, birth outcomes.