Salīdzinājums starp dzemdību ierosināšanu ar misoprostolu un misoprostolu kombinācijā ar balonkatetru.
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Date
2022
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Darba aktualitāte: Dzemdību ierosināšana ar misoprostolu kombinācijā ar balonkatetru Rīgas Dzemdību namā ir salīdzinoši jauna metode (izmanto apmēram divus gadus), tāpēc ir aktuāli salīdzināt šo metodi ar jau iepriekš izmantoto dzemdību ierosināšanas metodi (izmantojot tikai misoprostolu).
Darba mērķis: Izpētīt, kura no dzemdību ierosināšanas metodēm ir efektīvāka, izmantojot misoprostolu (sintētisks PGE1) vai misoprostolu kombinācijā ar balonkatetru.
Metodes un materiāli: Datu ieguvei pētījumam tika apkopotas Rīgas dzemdību nama pacientu dzemdību vēstures par laika periodu no 01.01.2019. līdz 22.09.2021.
No dzemdību vēsturēm tika apkopota informācija par sieviešu izglītību, vecumu, dzemdību 1. perioda ilgumu, dzemdību 2. perioda ilgumu, bezūdens perioda ilgumu, bērna svaru, garumu. Kā arī tika apkopota informācija par to, kuras dzemdības šīs bija pēc skaita, vai dzemdību laikā tika lietota epidurālā anestēzija, kāds bija dzemdību veids, kādas bija komplikācijas, sarežģījumi, kādas tika veiktas operācijas, manipulācijas pēc dzemdībām. Kā arī tika apkopota informācija par to, kāds bija dzemdību ierosināšanas iemesls, cik daudz bija iedotas misoprostola devas un kāds bija punktu skaits sākotnēji, izvērtējot pēc Bišopa skalas.
Pētījumā piedalījās 3174 sievietes, vecuma grupā no 15 līdz 46 gadiem. No tām 2390 sievietēm kā indukcijas metode bija misoprostols, 739 sievietēm bija misoprostols + balonkatetrs un 45 sievietēm bija tikai balonkatetrs. Pētījumā piedalījās sievietes ar normālu ĶMI.
Dati bija statistiski analizēti ar IBM SPSS Statistics 26 programmas palīdzību. Analīzes mērķis bija salīdzināt dzemdību ierosināšanas metodes (Misoprostols un Misoprostols + balonkatetrs).
Rezultāti: Hipotēze ir apstiprinājusies, jo 2. dzemdību perioda un bezūdens perioda ilgums bija īsāks misoprostols + balonkatetrs grupā, kā arī izmantotais misoprostola pulveru daudzums mazāks bija misoprostola + balonkatetra grupā. Misoprostola + balonkatetra grupā ir biežāk sastopami starpenes plīsumi, bet epiziotomijas 3,8x vairāk tiek veiktas misoprostola grupā, kā arī plīsumu šūšana biežāk tiek veikta misoprostola grupā. Dzemdību atrisināšana ar ķeizargrieziena operāciju visbiežāk ir misoprostola grupā. Bērna veselības stāvokļa novērtēšanu pēc Apgares skalas, vecuma un izglītības līmeņa atkarībā no dzemdību ierosināšanas metodes, nebija statistiski nozīmīgas atšķirības (>0,05).
Secinājumi: Pētījums pierādīja, ka dzemdību ierosināšanas metode misoprostols + balonkatetrs ir efektīvāka, jo ir īsāks laika periods līdz dzemdību atrisināšanai, ir nepieciešama mazāka misoprostola deva dzemdību ierosināšanai, kā arī ir mazāk komplikāciju dzemdībās, un veikto manipulāciju pēcdzemdību periodā, retāk sastopama dzemdību atrisināšana ar ķeizargrieziena operāciju.
Actuality: Induction of labor with Misoprostol in combination with a balloon catheter in the Riga Maternity Hospital is a relatively new method (used for about two years), so it is important to compare this method with the previously used method of induction of labor (using only misoprostol). Aim of the study: To investigate which of the methods of induction of labor is more effective: using misoprostol (synthetic PGE1) or misoprostol in combination with a balloon catheter. Methods and materials: To obtain data for the study, the birth histories of the patients of the Riga Maternity hospital for the period from 01.01.2019 until 22.09.2021 were collected. Information on women's education, age, duration of the 1st period of childbirth, duration of the 2nd period of childbirth, length of the anhydrous period, weight and length of the child was collected from medical histories. Data about the number of births, epidural anesthesia used during the birth, the type of birth, complications, surgeries, and post-natal manipulations were collected. The cause of labor, the number of misoprostol doses given, and the Bishop score were have been taken into account. The study involved 3,174 women in the 15-46 age group. 2,390 women had misoprostol as the induction method, 739 women had a misoprostol + ballon catheter and 45 women had a balloon catheter alone. Data were statistically analyzed using IBM SPSS Statistics 26. The aim of the analysis was to compare methods of inducing labor (misoprostol and misoprostol + balloon catheter). Results: The hypothesis was partially confirmed because the duration of the 2nd delivery period and the ruptured membrane period was shorter in the misoprostol + ballon catheter group. The doses of misoprostol used were lower in the misoprostol + ballon catheter group. The lowest count of epidural anesthesia use was in the misoprostol group. Peritoneal ruptures were more common in the misoprostol + ballon catheter group. Episiotomies were performed more common in the misoprostol group and perineal ruptures were more common in the misoprostol group. In the misoprostol + ballon catheter group, caesarean section were more common in misoprostol group. There were no statistically significant differences (p> 0.05) in the assessment of the Apgare score, age and level of education. Conclusions: The study showed, that the misoprostol + ballon catheter method of induction of labor is more effective, due to the shorter time to delivery, the lower dose of misoprostol required for induction of labor, the lower number of complications during labor and postpartum manipulations and cesarean section.
Actuality: Induction of labor with Misoprostol in combination with a balloon catheter in the Riga Maternity Hospital is a relatively new method (used for about two years), so it is important to compare this method with the previously used method of induction of labor (using only misoprostol). Aim of the study: To investigate which of the methods of induction of labor is more effective: using misoprostol (synthetic PGE1) or misoprostol in combination with a balloon catheter. Methods and materials: To obtain data for the study, the birth histories of the patients of the Riga Maternity hospital for the period from 01.01.2019 until 22.09.2021 were collected. Information on women's education, age, duration of the 1st period of childbirth, duration of the 2nd period of childbirth, length of the anhydrous period, weight and length of the child was collected from medical histories. Data about the number of births, epidural anesthesia used during the birth, the type of birth, complications, surgeries, and post-natal manipulations were collected. The cause of labor, the number of misoprostol doses given, and the Bishop score were have been taken into account. The study involved 3,174 women in the 15-46 age group. 2,390 women had misoprostol as the induction method, 739 women had a misoprostol + ballon catheter and 45 women had a balloon catheter alone. Data were statistically analyzed using IBM SPSS Statistics 26. The aim of the analysis was to compare methods of inducing labor (misoprostol and misoprostol + balloon catheter). Results: The hypothesis was partially confirmed because the duration of the 2nd delivery period and the ruptured membrane period was shorter in the misoprostol + ballon catheter group. The doses of misoprostol used were lower in the misoprostol + ballon catheter group. The lowest count of epidural anesthesia use was in the misoprostol group. Peritoneal ruptures were more common in the misoprostol + ballon catheter group. Episiotomies were performed more common in the misoprostol group and perineal ruptures were more common in the misoprostol group. In the misoprostol + ballon catheter group, caesarean section were more common in misoprostol group. There were no statistically significant differences (p> 0.05) in the assessment of the Apgare score, age and level of education. Conclusions: The study showed, that the misoprostol + ballon catheter method of induction of labor is more effective, due to the shorter time to delivery, the lower dose of misoprostol required for induction of labor, the lower number of complications during labor and postpartum manipulations and cesarean section.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
DZEMDĪBU IEROSINĀŠANAS METODES. BALONKATETRS. FOLEY KATETRS. MISOPROSTOLS., LABOR INDUCTION METHODS. CERVICAL RIPENING. FOLEY CATHETER. MISOPROSTOL.