DOĞUMDA İNDÜKSİYON UYGULANMA DURUMUNUN ACİL SEZARYEN DOĞUMA ETKİSİ

Year 2023, Volume: 4 Issue: 3, 192 - 198, 30.12.2023

Hilal Bal Şaraldı , Pirozhan Ekin , Zekiye Karaçam

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

Cited By: 1

Abstract

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.

Keywords

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

THE EFFECT OF INDUCTION OF LABOR ON EMERGENCY CESAREAN DELIVERY

Abstract

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.

Keywords

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

References

• Bay F, Bulut Ö. Doğum indüksiyonu: maternal, fetal-neonatal etkileri, ebenin rolü. KTO Karatay Üniversitesi Sağlık Bilimleri Dergisi. 2020;1(1):4-14.
• Erickson EN, Bailey JM, Colo SD, Carlson NS, Tilden EL. Induction of labor or expectant management? Birth outcomes for nulliparous individuals choosing midwifery care. Birth. 2021;48(4):501-513.
• Yeşilçicek Çalık K, Çoşar Çetin F. Normal doğum sonrası dönem. İstanbul, İstanbul Medikal Sağlık ve Yayıncılık. 2018;(1):37-48.
• Kokanalı MK, Kokanalı D, Güzel Aİ, Topçu HO, Cavkaytar S, Doğanay M. Term gebelikte ve uygun bishop skoru varlığında intravenöz sentetik oksitosin infüzyonu ile doğum indüksiyonu sonucuna etki eden faktörlerin analizi. Cukurova Medical Journal. 2015;40(2):317-325.
• Place K, Rahkonen L, Verho-Reischl N, Adler K, Heinonen S, Kruit H. Childbirth experience in induced labor: A prospective study using a validated childbirth experience questionnaire (CEQ) with a focus on the first birth. Plos One. 2022;17(10):e0274949.
• World Health Organization.WHO recommendations on intrapartum care for a positive childbirth experience. 2018; ISBN 978-92-4-155021.
• Alanwar A, Hussein SH, Allam HA, et al. Transvaginal sonographic measurement of cervical length versus Bishop score in labor induction at term for prediction of caesarean delivery. The Journal of Maternal-Fetal & Neonatal Medicine. 2021;34(13):2146-2153.
• Wormer KC, Bauer A, Williford AE. Bishop Score. In StatPearls. StatPearls Publishing. 2022. https://www.ncbi.nlm.nih.gov/books/NBK470368/#_NBK470368_pubdet_. Erişim Tarihi: 11.04.2023.
• Melkie A, Addisu D, Mekie M, Dagnew E. Failed induction of labor and its associated factors in Ethiopia: a systematic review and meta-analysis. Heliyon. 2021;7(3):e06415.
• Taşkın L. Doğum ve kadın sağlığı hemşireliği: amniyotomi. Ankara, Akademisyen Kitabevi. 2019;(16):378.
• Carlson NS, Dunn Amore A, Ellis JA, Page K, Schafer R. American college of nurse‐midwives clinical bulletin number 18: induction of labor. Journal of Midwifery & Women's Health. 2022;67(1):140-149.
• Şahin M, Erbil N. Normal doğum ve medikalizasyon. Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi. 2019;2(2):120-13.
• Freedman D, Brown AS, Shen L, Schaefer CA. Perinatal oxytocin increases the risk of offspring bipolar disorder and childhood cognitive impairment. Journal of Affective Disorders. 2015;173:65-72.
• Centers for Disease Control and Prevention. CDC USA Centers for Disease Control and Prevention Births data summary: natality 1995–2020. 2021. https://wonder.cdc.gov/wonder/help/natality.html. Erişim Tarihi: 15 Ocak 2023.
• Kruit H, Gissler M, Heinonen S, Rahkonen L. Breaking the myth: the association between the increasing incidence of labour induction and the rate of caesarean delivery in Finland - a nationwide medical birth register study. BMJ. 2022;12(7):e060161.
• Lueth GD, Kebede A, Medhanyie AA. Prevalence, outcomes and associated factors of labor induction among women delivered at public hospitals of Mekelle town-(a hospital based cross sectional study). BMC Pregnancy Childbirth. 2020;20:203.
• Karaçam Z, Ekmen H, Çalişir H. The use of perineal massage in the second stage of labor and follow-up of postpartum perineal outcomes. Health Care for Women İnternational. 2012;33(8):697-718.
• Karaçam Z, Kurnaz DA, Güneş G. Evaluating the content and quality of intrapartum care in vaginal births: an example of a state hospital. Turkish Journal of Obstetrics and Gynecology. 2017;14(1):10.
• Pınar S, Karaçam Z. Applying fundal pressure in the second stage of labour and its impact on mother and infant health. Health Care for Women İnternational. 2018;39(1):110-125.
• Hanson L. Doğum sürecini desteklemede kullanılan düşük teknolojili klinik müdahaleler: Membranların yapay rüptürü. 2018.
• T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. Kadın ve Üreme Dairesi Başkanlığı Anne Dostu Hastane Programı. 2017. https://hsgm.saglik.gov.tr/tr/kadin-ve-ureme-sagligi-programlari/anne-dostu-hastane-program%C4%B1.html. Erişim Tarihi: 25.12.2022.
• Elderhorst E, Ahmed RJ, Hutton EK, Darling EK. Birth outcomes for midwifery clients who begin postdates induction of labour under midwifery care compared with those who are transferred to obstetrical care. Journal of Obstetrics and Gynaecology Canada. 2019;41(10):1444-1452.
• Nippita TA, Porter M, Seeho SK, Morris JM, Roberts CL. Variation in clinical decision-making for induction of labour: a qualitative study. BMC Pregnancy and Childbirth. 2017;17(1):1-9.
• McCarthy CM, Meaney S. McCarthy M, Conners N, Russell N. Induction of labor: reviewing the past to improve the future. AJOG Global Reports. 2022;2(4):2666-5778.
• Zhu J, Xue L, Shen H. et al. Labor induction in China: a nationwide survey. BMC Pregnancy Childbirth. 2022;22:463.
• Yosef T, Getachew D. Proportion and outcome of ınduction of labor among mothers who delivered in Teaching Hospital, Southwest Ethiopia. Frontiers in Public Health. 2021;9:686682.
• Swift EM, Gunnarsdottir J, Zoega H, Bjarnadottir RI, Steingrimsdottir T, Einarsdottir K. Trends in labor induction indications: a 20-year population-based study. Acta Obstetricia et Gynecologica Scandinavica. 2022;101(12):1422-1430.
• Simpson K. Trends in labor induction in the united states, 1989 to 2020. MCN, The American Journal of Maternal/Child Nursing. 2022;47(4):235.
• Artuso H, Davis DL. Trends and characteristics of women undergoing induction of labour in a tertiary hospital setting: a cross-sectional study. Women and Birth. 2022;35(2):181-187.
• Tadesse T, Assefa N, Roba HS, Baye Y. Failed induction of labor and associated factors among women undergoing induction at University of Gondar Specialized Hospital, Northwest Ethiopia. BMC Pregnancy and Childbirth. 2022;22(1):175.
• Omerovic A, Pajek S, Anzeljc V, Mujezinovic F. Labor induction: change of indications and outcomes over time and future trends - a retrospective analysis. Clin. Exp. Obstet. Gynecol. 2022;49(5):102.
• Zhang QJ, Chen SW, Xu X, Zhang HL, Yan JY. Effect of induction of labor on maternal and perinatal outcomes in low-risk singleton pregnancies: a retrospective case-control study. Eur Rev Med Pharmacol Sci. 2022;26(16):5918-5925.
• Woretaw E, Teshome M, Alene M. Episiotomy practice and associated factors among mothers who gave birth at public health facilities in Metema district, northwest Ethiopia. Reprod Health. 2021;18:142.
• Gurol Urganci I, Jardine J, Carroll F, Fremeaux A, Muller P, Relph S, et al. Use of induction of labour and emergency caesarean section and perinatal outcomes in English maternity services: a national hospital-level study. BJOG. 2022;129:1899-1906.
• Guan P, Tang F, Sun G, et al. Prediction of emergency cesarean section by measurable maternal and fetal characteristics. Journal of Investigative Medicine. 2020;68:799-806.
• Buyuk GN, Sert UY, Oskovi Kaplan ZA, Kahyaoglu S. Oxytocin Versus Dinoprostone For Labor Induction in Multiparous Women with Unfavorable Cervix. Gynecology Obstetrics &Amp; Reproductive Medicine. 2021;27(2):123-127.
• Onah LN, Dim CC, Nwagha UI, Ozumba BC. Effect of early amniotomy on the outcome of spontaneous labour: a randomized controlled trial of pregnant women in Enugu, South-east Nigeria. African Health Sciences. 2015;15(4):1097-1103.
• De Vivo V, Carbone L, Saccone G, Magoga G, De Vivo G, Locci M, Zullo F, Berghella V. Early amniotomy after cervical ripening for induction of labor: a systematic review and meta-analysis of randomized controlled trials. American Journal of Obstetrics and Gynecology. 2020;222(4):320-329.