Risk factors for emergency cesarean section due to cephalopelvic disproportion in Phayao hospital
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Abstract
Background: According to the statistics of the labor room in Phayao Hospital found that the rate of cesarean section due to cephalopelvic disproportion (CPD) was likely to increase which cause of complications in both pregnant woman and neonate. Knowing of these risk factors might lead to proper management.
Objectives: The aim of this study was to study the risk factors for emergency cesarean section due to CPD in Phayao Hospital.
Methods: A Case-control study was designed. The population was pregnant women that admission to the labor room in Phayao Hospital from October 2017 to February 2019. 408 full medical records were collected and the sample was divided into 2 groups. 231 cases were the caesarean section and 177 cases were vaginal delivery. Study characteristics included age, symphysis-fundal height (SFH), pre-pregnancy weight, height, weight gain during pregnancy, Gestational age and gravidity were collected from patient medical records to the data collection form. Chi-square test or Fisher’s exact test were used for statistical comparisons as appropriate and analyzed risk factors with an odds ratio by backward stepwise multiple logistic regression. Power 0.8 and p-value<0.05 were used.
Results: Teenage pregnancy is less likely to have lower emergency cesarean section rate than adult pregnancy (OR = 0.13, 95%CI = 0.05 - 0.30) (p < 0.001). Nulliparity has more chance of emergency cesarean section than multiparity (OR = 11.11, 95%CI = 6.37 - 19.37) (p < 0.001) and SFH greater than 35 cm has more chance of emergency cesarean section than SFH less than or equal to 35 cm (OR = 3.54, 95%CI = 2.08 - 6.01) (p < 0.001).
Conclusions and Discussions: Risk factors for emergency cesarean surgery due to cephalopelvic disproportion in Phayao hospital are nulliparity and SFH greater 35 cm. We recommended that changing the practice guidelines of the labor room to report obstetrician in case of SFH more than 35 cm.
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References
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