Abstract | Cilj: Analizirati ishode elektivno inducirnih porođaja u Klinici za ženske bolesti i porode Kliničkog bolničkog centra (KBC) Split (Klinika).
Ispitanice i postupci: U istraživanje su bile uključene sve trudnoće kod kojih je porođaj elektivno induciran u dvogodišnjem razdoblju od 1. siječnja 2022. do 31. prosinca 2023. Podatci su prikupljeni iz Dnevnih progarama, Operacijskih i Rađaonskih protokola te Protokola Zavoda za neonatologiju Klinike. Ispitivana su obilježja trudnica i novorođenčadi.
Rezulati: Zabilježeno je 347 elektivnih indukcija porođaja što je 4,39% od svih porođaja. Najčešće su inducirani petkom, a najmanje ponedjeljkom. Porođaji su najčešće bili inducirani u 41. tjednu trudnoće (58,21%). Rodilje su većinom bile prvorotke (57,93%). Prostaglandinski pripravci su prevladavali kao metoda indukcije u 37. (66,67%) i 41. (58,91%) tjednu, a amniotomija i drip u ostalim tjednima (38. 76,67%; 39. 58,49%; 40. 60,71%). Trećina (34,01%) svih induciranih porođaja završena je hitnim carskim rezom. Porođaji inducirani Prepidilom® su značajno češće završavali hitnim carskim rezom u odnosu na ostale metode indukcije (Prepidil® 50,68%, amnitomija i drip 20,81%, Angusta® 28,85%). Porođaji inducirani Angustom® (28,57%) su u značajno manjem udjelu završavali hitnim carskim rezom od onih induciranih Prepidilom® (50,68%) (P=0,032). Prvorotkama je porođaj češće završen hitnim carskim rezom ako je za metodu indukcije korišten Prepidil® (61,60%; P=0,009) ili amnitomija i drip (31,82%; P=0,000). Indukcija porođaja Angustom® (35,00%) u prvorotki značajno smanjuje udio hitnog carskog reza u usporedbi s Prepidilom® (61,61%) (P=0,026).
Zaključci: U ispitivanom periodu značajno više porođaja je bilo inducirano petkom, a najmanje ponedjeljkom. Korištenje Prepidila® kao metode indukcije rezultiralo je češćim hitnim carskim rezom. Prvorotke su značajno češće rađale hitnim carskim rezom kod indukcije porođaja Prepidilom® ili amniotomijom i dripom u odnosu na višerotke. Indukcija porođaja Angustom® kod prvorotki je u značajno manjem udjelu završila hitnim carskim rezom u usporedbi s Prepidilom®. Najčešća indikacija za indukciju je bilo prekoračenje termina. |
Abstract (english) | Objectives: Analysis of the outcomes of elective induction of labor at the University Hospital of Split (Clinic).
Subjects and methods: The study included all pregnancies in which labor was electively induced over a two-year period from January 1, 2022, to December 31, 2023. Data were collected from Daily programs, Birth and Operating protocols of the Clinic. Characteristics of pregnant women and newborns were examined.
Results: A total of 347 elective inductions of labor were recorded, accounting for 4.39% of all deliveries. Inductions were most commonly performed on Fridays and least commonly on Mondays. Inductions most frequently occurred in the 41st week of pregnancy (58.21%). The majority of women were first-time mothers (57.93%). Prostaglandin preparations were the predominant method of induction in the 37th (66.67%) and 41st (58.91%) weeks, while amniotomy and oxytocin drip were used in other weeks (38th week: 76.67%; 39th week: 58.49%; 40th week: 60.71%). A third (34.01%) of all induced labors ended in emergency cesarean sections. Labors induced with Prepidil® were significantly more likely to end in emergency cesarean sections compared to other methods of induction (Prepidil® 50.68%, amniotomy and drip 20.81%, Angusta® 28.85%). Labors induced with Angusta® (28.57%) had a significantly lower rate of emergency cesarean sections than those induced with Prepidil® (50.68%) (P=0.032). First-time mothers were more likely to have an emergency cesarean section if Prepidil® (61.60%; P=0.009) or amniotomy and drip (31.82%; P=0.000) were used for induction. Induction with Angusta® (35.00%) in first-time mothers significantly reduced the rate of emergency cesarean sections compared to Prepidil® (61.61%) (P=0.026).
Conclusions: During the study period, significantly more labors were induced on Fridays, and the least on Mondays. The use of Prepidil® as an induction method resulted in more frequent emergency cesarean sections. First-time mothers were significantly more likely to undergo emergency cesarean sections with induction using Prepidil® or amniotomy and drip compared to multiparous women. Induction with Angusta® in first-time mothers resulted in significantly fewer emergency cesarean sections compared to Prepidil®. The most common indication for induction was post-term pregnancy. |