Indukcija poroda in izidi poroda - analiza podatkov za Slovenijo : diplomsko delo

Bezjak, Katja (author), Mivšek, Ana Polona (mentor)

Uvod: V zadnjih letih je zaznati naraščanje števila porodniških intervencij, predvsem indukcij porodov. Njihov namen je zagotoviti boljše porodne izide tako za žensko kot za otroka. Vendar pa raziskovalci v svojih raziskavah prihajajo do nekonsistentnih rezultatov glede prednosti in slabosti indukcij porodov. Namen: Namena diplomskega dela sta bila predstaviti spreminjanje trendov na področju indukcij poroda v Sloveniji od leta 2013 do leta 2017 in raziskati, kako se potek in dokončanje induciranih porodov razlikujeta od spontanih porodov brez stimulacije ter glede na posamezno metodo indukcije. Metode dela: Izvedena je bila retrospektivna kvantitativna raziskava podatkov Nacionalnega perinatalnega informacijskega sistema za enoplodne nosečnosti za obdobje od leta 2013 do leta 2017. V analizo so bili vključeni inducirani porodi in spontani porodi brez stimulacije. S testoma Hi-kvadrat in ANOVA smo ugotavljali razlike v izidih poroda med induciranimi porodi in spontanimi porodi brez stimulacije ter razlike v izidih poroda med posameznimi metodami indukcije poroda. Rezultati: V Sloveniji je bilo med letoma 2013 in 2017 zaznati naraščanje števila induciranih porodov. Inducirani porodi so, v primerjavi s spontanimi porodi brez stimulacije, trajali dlje časa in so bili povezani z več nepravilnostmi med porodom, več instrumentalno in operativno dokončanimi porodi, večjim deležem epiziotomij in pogostejšo potrebo po ročnem luščenju placente ter iztipanju maternice, prav tako pa je bilo med njimi več zapletov tretje porodne dobe in potrebe po uporabi analgezije. Na porodne izide v določeni meri vpliva tudi metoda indukcije. Razprava in zaključek: Tako indukcija poroda kot tudi stimulacija poroda sta se izkazali kot pomembna dejavnika za slabše porodne izide, medtem ko na porodne izide pri induciranih porodih do neke mere vpliva tudi izbor metode za indukcijo poroda. Glede na to, da je indukcija poroda povezana s slabšimi porodni izidi, število indukcij poroda pa narašča, je to pomemben javnozdravstveni problem, zato bi bilo smiselno uvesti smernice in priporočila, s katerimi bi omejili oziroma zmanjšali naraščanje indukcij porodov.

• Language: Slovenian
• Keywords: indukcija poroda, stimulacija poroda, dokončanje poroda, porodni izidi
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2019
• PID: 20.500.12556/RUL-112843
• COBISS.SI-ID: 5731435
• Publication date in RUL: 15.11.2019

Secondary language

• Language: English
• Title: Induction of labour and birth outcomes - data analysis for Slovenia : diploma work

Abstract

Introduction: In recent years, we have witnessed an increase in the number of obstetric interventions, especially in induction of labour. The purpose of an intervention is to ensure a better labour outcome for both a woman and her baby. However, studies have revealed inconsistencies in results regarding the advantages and disadvantages of induction of labour. Purpose: The purpose of this diploma work is to present the changing trends in induction of labour in Slovenia from 2013 to 2017, and to explore the differences between induced labours and spontaneous labours without stimulation in terms of the course and outcome of labour. We will also research how induced labours differ based on method of induction of labour that was used. Methods: We conducted a retrospective quantitative research into data on the singleton pregnancies between 2013 and 2017 gathered by the National Perinatal Information System. Our analysis included induced labours and spontaneous labours without stimulation. We explored the differences in labour outcomes between induced labours and spontaneous labours without stimulation using the Chi-squared test and the ANOVA test. We also explored the differences in induced labours based on the method of induction of labour that was used. Results: Between 2013 and 2017, the number of induced labours in Slovenia was increasing. Induced labours, compared to spontaneous labours without stimulation, took longer and were linked to more abnormalities during labour. They were also linked to more instrumental and operative deliveries, a higher rate of episiotomy, and an increased need for manual removal of placenta. We noted more complications of the third stage of labour, and a greater need to use analgesia. Birth outcomes can, to a certain extent, also be affected by an method of induction of labour. Discussion and conclusion: Induction of labour and stimulation of labour have proven to be important factors for poorer birth outcomes, while the birth outcomes of an induced labour is also affected by the method of induction of labour that was used. Considering that labour induction is linked to poorer birth outcomes, while the number of induced labours is still increasing, we are facing a major public health issue. Therefore, it would be reasonable to introduce guidelines and recommendations to limit or reduce the rise of induced labours.

• Keywords: induction of labour, stimulation of labour, mode of delivery, birth outcomes