III.dzemdību perioda sarežģījumi pirmdzemdētājām vecumā virs 35 gadiem
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Date
2020
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Nosaukums - III dzemdību perioda sarežģījumi pirmdzemdētājām virs 35 gadiem.
Ievads un teorētiskais pamatojums - pēdējo desmitu gadu laikā ir pieaudzis pirmdzemdētāju vecums visās pasaules valstīs (Nordic perinatal statistics, 2014). Grūtnieces, kuru vecums pārsniedz 35 gadus, tiek iekļautas augsta riska grūtniecības grupā (Slimību profilakses un kontroles centrs. Augsta riska grūtniecība nevēlamam iznākumam).
Teorētiskajā pamatojumā ir sniegta informācija par pirmdzemdētāju vecuma pieaugumu, tā iemesliem, grūtniecības, dzemdību, pēcdzemdību sarežģījumu un sistēmisko saslimšanu risku pieaugumu līdz ar vecuma pieaugumu, kā arī par III dzemdību perioda sarežģījumiem.
Mērķis - noskaidrot, vai pirmdzemdētājām vecumā virs 35 gadiem palielinās III dzemdību perioda sarežģījumu skaits.
Metodoloģija - pētījuma grupa bija pirmdzemdētājas, kuras ir vecumā no 35 līdz 42 gadiem, ar iznestu viena augļa fizioloģiski noritošu grūtniecības gaitu. Datu ievākšanai tika izstrādāts pētījuma protokols par pirmdzemdētāju vecumu un iespējamiem III dzemdību perioda sarežģījumiem. No 2020. gada februāra līdz martam tika ievākti pētāmās grupas dati, kopā tika analizētas 1052 dzemdību vēstures. Pētījuma ietvaros tika piesaistīti trīs eksperti: ginekologi – dzemdību speciālisti un vecmātes, kuru darba pieredze noteiktajā profesijā ir vismaz 10 gadi. Tika aprobēta daļēji strukturēta intervija, tā sastāvēja no sešiem jautājumiem par III dzemdību perioda sarežģījumiem, ekspertu pieredzi, novērojumiem praksē un iegūtajiem datiem dzemdību iestādē. Intervijas norisinājās telefoniski 2020. gada maijā.
Rezultāti – statistiski nozīmīga saistība (p < 0,05) tika atrasta tikai starp diviem sarežģījumiem: hemorāģiju un dzemdes atoniju.
Eksperti norāda, ka biežākie III dzemdību perioda sarežģījumi ir hemorāģija un patstāvīga placentas neatdalīšanās 30 minūšu laikā.
Secinājumi - pirmdzemdētājām virs 35 gadu vecuma biežāki ir placentārā perioda sarežģījumi, kas saistīti ar placentas piestiprināšanās patoloģijām. Vienai primiparai, kuras vecums pārsniedz 35 gadus, III dzemdību perioda sarežģījumi var būt vairāki, ne tikai viens.
Atslēgas vārdi: novēlota grūtniecība, palielināts mātes vecums, trešā dzemdību perioda komplikācijas, placentārā perioda komplikācijas, pirmdzemdētājas vecumā virs 35 gadiem, primiparas un ART, palielināts mātes vecums un primipara un komplikācijas.
Tilte - Complications ir third period of labour in primipara women aged over 35. Introduction and backgrund - during the last 10 years, the age of primiparous women has increased in all countries of the world (Nordic perinatal statistics, 2014). Pregnant women over the age of 35 are included in high risk pregnancy group (SPKC. Augsta riska grūtniecība nevēlamam iznākumam). In the theoretical explanation, there is information about primiparous women’s increase in age, it’s causes, pregnancy, labour, postpartum complications and the risk increase of systematic illnesses in correlation with age increase, as well as III period of labour complications. Objective – find out if primiparous women over the age of 35 have an increased amount of III childbirth period complications. Methodology - the research group were primiparous women aged 35 to 42 with mature singleton physiological ongoing pregnancy process. For the collection of data, a protocol was developed featuring the primiparous women’s age and possible III period of labour complications. Data were collected from February till March of year 2020 and 1052 labour histories were analyzed. There were three experts who joined the research: gynecologists – obstetric specialists and midwives who had atleast 10 years of experience in the mentioned field. A semi - structured interview was approbated, it consisted of six questions about III period labour complications, the experience of experts, practical observations and the collected data from birth institution. Interviews were held by phone in May of 2020. Results and concusion – the most frequent III period of labour complication of primiparous women aged over 35 was found to be placenta adhaerens totalis and placenta adhaerens partialis. Statistically relevant connection (p <0,05) was found only between two complications: hemmorhage and uterine atony. Experts indicate that the most often III period of labour complations in their experience are hemmorhage and independent placenta non-seperation within 30 minutes. Key words: delayed childbearing, AMA (advanced maternal age), third period of labour complications, placental period complications, primiparous women over 35, primiparous and ART, AMA and primiparous and complications.
Tilte - Complications ir third period of labour in primipara women aged over 35. Introduction and backgrund - during the last 10 years, the age of primiparous women has increased in all countries of the world (Nordic perinatal statistics, 2014). Pregnant women over the age of 35 are included in high risk pregnancy group (SPKC. Augsta riska grūtniecība nevēlamam iznākumam). In the theoretical explanation, there is information about primiparous women’s increase in age, it’s causes, pregnancy, labour, postpartum complications and the risk increase of systematic illnesses in correlation with age increase, as well as III period of labour complications. Objective – find out if primiparous women over the age of 35 have an increased amount of III childbirth period complications. Methodology - the research group were primiparous women aged 35 to 42 with mature singleton physiological ongoing pregnancy process. For the collection of data, a protocol was developed featuring the primiparous women’s age and possible III period of labour complications. Data were collected from February till March of year 2020 and 1052 labour histories were analyzed. There were three experts who joined the research: gynecologists – obstetric specialists and midwives who had atleast 10 years of experience in the mentioned field. A semi - structured interview was approbated, it consisted of six questions about III period labour complications, the experience of experts, practical observations and the collected data from birth institution. Interviews were held by phone in May of 2020. Results and concusion – the most frequent III period of labour complication of primiparous women aged over 35 was found to be placenta adhaerens totalis and placenta adhaerens partialis. Statistically relevant connection (p <0,05) was found only between two complications: hemmorhage and uterine atony. Experts indicate that the most often III period of labour complations in their experience are hemmorhage and independent placenta non-seperation within 30 minutes. Key words: delayed childbearing, AMA (advanced maternal age), third period of labour complications, placental period complications, primiparous women over 35, primiparous and ART, AMA and primiparous and complications.
Description
Vecmāte
Midwifery
Veselības aprūpe
Health Care
Midwifery
Veselības aprūpe
Health Care
Keywords
Atslēgas vārdi: novēlota grūtniecība, palielināts mātes vecums, trešā dzemdību perioda komplikācijas, placentārā perioda komplikācijas, pirmdzemdētājas vecumā virs 35 gadiem, primiparas un ART, palielināts mātes vecums un primipara un komplikācijas., Key words: delayed childbearing, AMA (advanced maternal age), third period of labour complications, placental period complications, primiparous women over 35, primiparous and ART, AMA and primiparous and complications.