Vpliv načina poroda na tveganje za intrakranialne krvavitve pri novorojenčku

prospektivna populacijska kohortna raziskava

  • Nika Buh Zdravstvena fakulteta Univerze v Ljubljani, Oddelek za babištvo, Zdravstvena pot 5, 1000 Ljubljana, Slovenija
  • Miha Lučovnik Univerzitetni klinični center Ljubljana, Ginekološka klinika, KO za perinatologijo, Šlajmerjeva 4, 1000 Ljubljana, Slovenija https://orcid.org/0000-0003-2708-9175
Ključne besede: porod, carski rez, intrakranialna krvavitev, vakuumska ekstrakcija

Povzetek

Uvod: Namen raziskave je bil preučiti povezavo med načinom poroda in tveganjem za intrakranialno krvavitev pri novorojenčku.
Metode: Analizirali smo podatke iz Nacionalnega perinatalnega informacijskega sistema (NPIS) za obdobje od leta 2002 do leta 2016. Vključili smo prvorodnice, ki so rodile od 2500 do 4000 g težke enojčke v glavični vstavi. Za primerjavo deležev intrakranialne krvavitve pri vakuumski ekstrakciji in drugih načinih poroda smo uporabili Hi-kvadrat test (p < 0,05 signifikantno).
Rezultati: Vključili smo 125393 porodov: 5438 (4 %) načrtovanih carskih rezov, 97764 (78 %) spontanih vaginalnih porodov, 15577 (12 %) urgentnih carskih rezov in 6614 (5 %) vakuumskih ekstrakcij. Diagnosticiranih je bilo 17 (0.14 / 1000) intrakranialnih krvavitev: 12 po spontanem vaginalnem porodu, dve po urgentnem carskem rezu in tri po vakuumski ekstrakciji. Vakuumska ekstrakcija je bila povezana s statistično pomembno povečanim tveganjem za intrakranialno krvavitev v primerjavi s spontanim vaginalnim porodom (razmerje obetov (RO) 3,70; 95% interval zaupanja (IZ) 1,04−13,10), a ne v primerjavi z urgentnim carskim rezom (RO 3,54; 95% IZ 0,59−21,16).
Diskusija in zaključek: Vakuumska ekstrakcija je povezana s povečanim tveganjem za intrakranialno krvavitev v primerjavi s spontanim vaginalnim porodom, vendar je absolutno tveganje majhno. Tveganje za intrakranialno krvavitev se ne razlikuje pomembno glede na operativno dokončanje poroda z vakuumsko ekstrakcijo ali urgentni carski rez.

Prenosi

Podatki o prenosih še niso na voljo.

Biografije avtorja

Nika Buh, Zdravstvena fakulteta Univerze v Ljubljani, Oddelek za babištvo, Zdravstvena pot 5, 1000 Ljubljana, Slovenija

dipl. babica 

Miha Lučovnik, Univerzitetni klinični center Ljubljana, Ginekološka klinika, KO za perinatologijo, Šlajmerjeva 4, 1000 Ljubljana, Slovenija

doc. dr., dr. med.

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Objavljeno
2019-09-15
Kako citirati
Buh, N. in Lučovnik, M. (2019) Vpliv načina poroda na tveganje za intrakranialne krvavitve pri novorojenčku, Obzornik zdravstvene nege, 53(3), str. 194–199. doi: 10.14528/snr.2019.53.3.751.
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