diplomsko delo
Manca Starman (Author), Miha Lučovnik (Reviewer), Anita Prelec (Mentor), Saša Matko (Co-mentor)

Abstract

Uvod: V preteklosti so se carskemu rezu zaradi visoke stopnje umrljivosti mater izogibali, danes pa je to najpogosteje izvajan operativni poseg pri ženskah v rodni dobi. Do leta 1970 je v porodništvu prevladovalo načelo ,,enkrat carski rez, vedno carski rez“, kar je privedlo do vztrajnega naraščanja števila teh posegov skozi celotno 20. stoletje. Ponavljajoči se carski rezi so tako predstavljali skoraj 40 % vseh. Leta 1985 je pod okriljem Svetovne zdravstvene organizacije potekalo srečanje strokovnjakov, namenjeno oceni primernosti in uporabi porodniške tehnologije. Udeleženci so izrazili zaskrbljenost zaradi naraščajočega števila carskih rezov in poudarili, da za nobeno regijo ni medicinsko upravičeno, da delež teh posegov presega 10–15 %. Kljub temu so stopnje carskih rezov v večini držav še vedno višje od priporočene meje (z izjemo manj razvitih območij). Eden izmed ključnih ukrepov za znižanje te številke je spodbujanje poskusa vaginalnega poroda po carskem rezu. Namen: Namen diplomskega dela je analizirati pojavnost in uspešnost poskusa poroda po carskem rezu v obdobju 2014?2024 v Bolnišnici za ginekologijo in porodništvo Kranj. Raziskali smo tudi naslednje dejavnike, ki vplivajo na uspešnost: starost porodnice, indeks telesne mase, način začetka poroda, prisotnost gestacijskega diabetesa, placente praevie, rupture maternice, večplodne nosečnosti in medenične vstave ploda. S tem želimo prispevati k boljšemu razumevanju pogojev, pod katerimi je poskus poroda po carskem rezu varen in uspešen. Metode dela: V diplomskem delu smo uporabili kvantitativni, deskriptivni raziskovalni pristop, ki temelji na pregledu literature in analizi statističnih podatkov Bolnišnice za ginekologijo in porodništvo Kranj za obdobje 2014–2024. Podatke smo črpali iz Perinatalnega informacijskega sistema Republike Slovenije, porodnih zapisnikov, knjig porodov in informacijskega sistema Bolnišnice za ginekologijo in porodništvo Kranj. V analizo smo vključili vse porodnice z vsaj enim predhodnim carskim rezom. Rezultati: V obdobju 2014?2024 je povprečje poskusov poroda po carskem rezu v raziskavi znašalo 51 %, povprečje uspešnosti poskusov poroda po carskem rezu pa 69 %. K višji uspešnosti so prispevali dejavniki, kot so starostna skupina 21–25 let (72 %), pacientke z normalnim indeksom telesne mase (69 %) in spontan začetek poroda (70 %). Razprava in zaključek: Pojavnost uspešnega poskusa vaginalnega poroda po carskem rezu v preučevanem vzorcu je relativno visoka in primerljiva z najboljšimi mednarodnimi praksami. Ključni dejavniki, ki povečujejo verjetnost uspeha, so nižja starost, normalen indeks telesne mase, spontan začetek poroda in odsotnost dejavnikov tveganja v porodni anamnezi.

Keywords

diplomska dela;babištvo;poskus vaginalnega poroda po predhodnem carskem rezu;vaginalni porod;carski rez;dejavniki tveganja;

Data

Language: Slovenian
Year of publishing:
Typology: 2.11 - Undergraduate Thesis
Organization: UL ZF - University College of Health Studies
Publisher: [M. Starman]
UDC: 618.2/.7
COBISS: 241273091 Link will open in a new window
Views: 95
Downloads: 23
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Other data

Secondary language: English
Secondary title: Trial of labour after caesarean – data analysis for the Hospital for Gynaecology and Obstetrics Kranj
Secondary abstract: Introduction: In the past, caesarean section was usually avoided due to its high maternal mortality rate, but today it has become the most commonly performed surgical procedure among women of childbearing age. Until 1970, the obstetric saying ,,once a caesarean, always a caesarean” prevailed, which led to a steady rise in the number of these operations throughout the 20th century. Repeat caesarean sections therefore came to represent almost 40 % of all caesarean sections. In 1985, under the auspices of the World Health Organization, experts convened to evaluate the appropriateness and use of obstetric technology. The participants expressed concern about the increasing number of caesarean deliveries and emphasized that no world region has a medical justification for caesarean rates exceeding 10–15 %. Nevertheless, the rates in most countries remain above this recommended threshold, except for less developed areas. One of the key measures to lower this figure is to encourage a trial of vaginal birth after the caesarean section. Purpose: The aim of this thesis is to analyze the incidence and success of trial of labor after caesarean section during the 2014–2024 period at the Kranj Hospital for Gynecology and Obstetrics. We also investigate the following factors that influence the success of trial of labor after caesarean section: maternal age, body mass index, labor onset method, presence of gestational diabetes, placenta previa, uterine rupture, multiple pregnancy and fetal malpresentation. In doing so, we hope to contribute to a better understanding of the conditions under which a trial of labor after caesarean is safe and successful. Methods: In this thesis, a quantitative, descriptive research method based on a systematic review of the relevant literature and an analysis of statistical data from the Kranj Hospital for Gynecology and Obstetrics covering the period 2014–2024 was used. The data was drawn from the Perinatal Information System of the Republic of Slovenia, delivery records, birth registries, and the hospital’s own information system. Our analysis includes all women with at least one prior caesarean section in the researched period. Results: By researching this data, we found that the average rate of trial of labor after caesarean section was 51 %, while the success rate of those trials was 69 %. Higher success rates were observed in the following subgroups: women aged 21–25 years (72 %), patients with a normal body mass index (69 %) and patients with a spontaneous onset of labor (70 %). Discussion and conclusion: The incidence of successful trial of labor after caesarean section in the studied sample is relatively high and comparable to the best international practices. The key factors that increase the likelihood of success include younger maternal age, normal body mass index, spontaneous onset of labor, and the absence of negative obstetric history.
Secondary keywords: diploma theses;midwifery;trial of labor after cesarean section;vaginal labor;cesarean section;risk factors;
Type (COBISS): Bachelor thesis/paper
Study programme: 0
Thesis comment: Univ. v Ljubljani, Zdravstvena fak., Oddelek za babištvo
Pages: 38 str., [1] str. pril.
ID: 26712127