DOĞUMDA İNDÜKSİYON UYGULANMA DURUMUNUN ACİL SEZARYEN DOĞUMA ETKİSİ

Yıl 2023, Cilt: 4 Sayı: 3, 192 - 198, 30.12.2023

Hilal Bal Şaraldı Pirozhan Ekin Zekiye Karaçam

https://doi.org/10.52831/kjhs.1277028

Öz

Amaç: Bu araştırma doğumda indüksiyon uygulanma durumunun acil sezaryen doğuma etkisini ve ilişkili durumların belirlenmesi amacıyla yapıldı.
Yöntem: Araştırma analitik-kesitsel olarak Ocak-Aralık 2022 tarihleri arasında yapıldı. Araştırma evrenini, bir kamu hastanesinde miadında doğum yapan ve gelişigüzel örnekleme yöntemi ile belirlenen 350 kadın oluşturdu. Veriler Anket Formu ile toplandı ve tanımlayıcı istatistikler, Ki-kare testi ve Lojistik Regresyon ile analiz edildi.
Bulgular: Araştırmadaki kadınların %88.9’una doğum indüksiyonu uygulandığı, indüksiyon türlerinin %42.9 oranında amniyotomi, %10.6 oranında oksitosin, %8.9 oranında prostoglandin olduğu ve kadınların %18.9’una acil sezaryen uygulandığı bulundu. Çoklu lojistik regresyon analizinde, istatistiksel olarak anlamlı bir şekilde, prostoglandin uygulananlarda acil sezaryen doğum olasılığının 10.8 kat (OR= 10.825; p<0.001), gebelik haftasının 1.72 kat (OR= 1.718; p<0.001) artırdığı, ancak öğrenim düzeyi lise ve gelir düzeyi düşük olanlarda, gelir getiren işte çalışanlarda, gebeliğini isteyenlerde ve amniyon mayide mekonyum bulunanlarda prostoglandin uygulama olasılığının daha az olduğu saptandı. Yine, oksitosin uygulananlarda amniyon mayide mekonyum bulunma olasılığının 3.9 kat (OR= 3.947; p<0.001) ve postpartum kanama olasılığı 3.2 kat (OR=3.246; p=0.015) daha fazla iken, okur-yazar olan/olmayanlarda ve gebelik haftası daha düşük olanlarda daha az olduğu saptandı. İlave olarak ilkokul/ortaokul (OR= 0.234; p=0.001) ve lise (OR= 0.133; p<0.001) eğitim düzeyi, gelir düzeyi düşük (OR= 0.467; p=0.016), sağlık güvencesi (OR= 0.372; p=0.002) ve acil sezaryen (OR= 0.072; p=0.001) olanlar ve epizyotomi uygulananlarda (OR= 0.484; p=0.024) amniyotomi uygulanma olasılığının daha az olduğu belirlendi.
Sonuç: Bu araştırma indüksiyon uygulanma sıklığının oldukça yayın olduğu ve bu durumun acil sezaryen ihtimalini artırdığı sonuçlarını açığa çıkarmıştır. Doğuma indüksiyon ile müdahalelerin azaltılması yönünde ebelerin de iş birliği ile kurum sağlık politikaları oluşturularak intrapartum bakım hizmetlerinin kanıta dayalı uygulamalara göre yürütülmesi ile anne-bebek sağlığının gelişimine katkı sağlanabilir.

Anahtar Kelimeler

Doğum İndüksiyonu, Doğum, Anne-Yenidoğan Sağlığı, Sezaryen Doğum, Ebelik

THE EFFECT OF INDUCTION OF LABOR ON EMERGENCY CESAREAN DELIVERY

Öz

Objective: This study was conducted to determine the effect of induction of labor on emergency cesarean delivery and related conditions.
Method: The study was conducted analytically cross-sectionally between January and December 2022. The study population consisted of 350 women who gave birth at term in a public hospital and were determined by random sampling method. Data were collected using a questionnaire and analyzed using descriptive statistics, Chi-square test and Logistic Regression.
Results: It was found that 88.9% of the women in the study underwent labor induction, 42.9% of the induction types were amniotomy, 10.6% were oxytocin, 8.9% were prostoglandin, and 18.9% of the women underwent emergency cesarean section. In multiple logistic regression analysis, it was found that the probability of emergency cesarean delivery increased 10.8 times (OR=10.825; p<0.001) and the gestational week increased 1.72 times (OR=1.718; p<0.001) in those who were administered prostoglandin, but the probability of prostoglandin administration was less in those with high school education and low income level, those with income-generating jobs, those who wanted their pregnancy and those with meconium in amniotic fluid. Again, the likelihood of meconium in amniotic fluid was 3.9 times higher (OR=3.947; p<0.001) and the likelihood of postpartum hemorrhage was 3.2 times higher (OR=3.246; p=0.015) in those who were administered oxytocin, whereas it was lower in those who were literate/illiterate and those with a lower gestational week. In addition, it was found to be lower in primary/middle school (OR= 0.234; p=0.001) and high school (OR= 0.133; p<0.001) educational level, low income (OR=0.467; p=0.016), health insurance (OR=0.372; p=0.002) and emergency cesarean section (OR=0.072; p=0.001) and those who underwent episiotomy (OR=0.484; p=0.024) were less likely to undergo amniotomy.
Conclusion: This study revealed that the frequency of induction of labor was highly broadcast and this increased the likelihood of emergency cesarean section. In order to reduce interventions with induction of labor, institutional health policies can be established with the cooperation of midwives and intrapartum care services can be carried out according to evidence-based practices and contribute to the development of mother-baby health.

Anahtar Kelimeler

Induction of Labor, Delivery, Maternal-Newborn Health, Cesarean Delivery, Midwifery

Kaynakça

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