Author/Editor		Petrova, Tanja; Lučovnik, Miha
Title		Vpliv ovite popkovnice na pojavnost operativnega dokončanja porod
Translated title		Impact of wrapped umbilical cord on the incidence of operative delivery
Type		članek
Vol. and No.		Letnik 48, št. 3
Publication year		2014
Volume		str. 215-219
ISSN		1318-2951 - Obzornik Zdravstvene Nege
Language		slv
Abstract		Uvod: Pojavnost ovite popkovnice ob porodu je po tujih podatkih 6%37 %. Ovita popkovnica je lahko povezana z nekaterimi zapleti v nosečnosti, vendar njen vpliv na fetalni distres med porodom in operativno dokončanje poroda še ni dovolj raziskan. Metode: Izvedli smo retrospektivno kohortno raziskavo podatkov Perinatalnega informacijskega sistema Republike Slovenije za obdobje 2002%2011. Vključili smo enojčke, rojene v glavični vstavi med 37. in 42. tednom. S testom hi-kvadrat smo ugotavljali povezavo med ovito popkovnico in operativnim dokončanjem poroda. Z multiplo logistično regresijo smo poleg vpliva ovite popkovine analizirali še potencialno moteče dejavnike: pariteta, trajanje poroda 9 ur in več, porodna teža pod 5. centilo in začetek poroda. Rezultati: Vključili smo 173.776 porodov. Popkovnica je bila ovita pri 57.174 (33 %). Ovita popkovnica je bila v univariatni analizi povezana z operativnim dokončanjem poroda (p < 0,001), vendar v multivariatni analizi ni bila neodvisni dejavnik tveganja (p = 0,311), pač pa so to bili prva nosečnost, dolgotrajni porod, indukcija in porodna teža pod 5. centilo (p < 0,001). Diskusija in zaključek: V slovenskih porodnišnicah je med porodi enojčkov v glavični vstavi ob terminu 33 % takih z ovito popkovnico, kar je več, kot navaja večina tujih raziskav. Ovita popkovnica ni neodvisni dejavnik tveganja za operativno dokončanje poroda.Introduction: The incidence of umbilical cord wrapped around foetus' body parts at birth in the Slovenian population is not yet known. According to the statistics from foreign countries, the incidence of wrapped cord during labour is 6 % to 37 %. In addition, it is not known whether wrapped cord affects the occurrence of foetal distress during labour and leads to a higher incidence of operative delivery. Methods: The research used the retrospective cohort study based on the data from the National Perinatal Information System. We analysed the data for period 2002 through 2011. We have included all deliveries between 37 0/7 and 41 6/7weeks. Chi-square test was used to determine the relationship between wrapped umbilical cord and operative delivery (operative vaginal delivery - vacuum, forceps or caesarean section) (p < 0.05 significant). Multivariate logistic regression was used to analyse the impact of wrapped cord on operative delivery controlling for potentially confounding factors: labour duration % 9hours, birth weight < 5th centile for gestational age, and onset of labour (induction vs. spontaneous). Results: We included 173776 deliveries. Among these, a nuchal cord was present in 57174 cases (33 %). In the univariate analysis, the nuchal cord was significantly associated with operative delivery due to foetal distress (p < 0.001). In multivariate analysis, however, nuchal cord was not an independent risk factor for the operative delivery (p = 0.311), as were the first pregnancy, prolonged labour, induction and SGA (birth weight < 5th centile). Discussion and conclusion: The incidence of nuchal cord in term deliveries in Slovenia is 33 %. Wrapped umbilical cord is not an independent risk factor for operative delivery.
Keywords		carski rez fetalni distres vakuumska ekstrakcija forceps caesarean section foetal distress vacuum extraction forceps