PDF(Sci-hub)
Abstract：
OBJECTIVE: This study aims to compare two techniques (External pop-out versus classic technique) for delivery of the fetal head during elective cesarean section (CS).The potential clinical predictors associated with unintended uterine incision extension during fetal head delivery among women delivered by elective CS were also assessed.
METHODS: A randomized clinical trial conducted at a tertiary University hospital between February 2017 and January 2019. Participants were randomly assigned to the classic head delivery technique (group I) or external Pop-out (EPO) technique (group II). The primary outcome was the incidence of unintended uterine incision extension during elective CS. A logistic regression model was utilized to examine the association between patient\'s characteristics and the occurrence of unintended uterine incision extension.
RESULTS: Participants in both groups (455 women in each group) had similar demographic characteristics. The EPO group had a significantly lower incidence of uterine incision extension than the classic group (p = 0.006). The operative time was significantly shorter in the EPO group (p = 0.000), which was also significantly easier than the classic technique (p = 0.001). The high body mass index (p = 0.004), previous delivery by CS (p = 0.010), high birth weight (p = 0.001) and the classic technique for head delivery (p = 0.002) were significant predictors for uterine incision tears.
CONCLUSIONS: EPO technique is an easy technique for fetal head delivery during elective CS with a lower risk of uterine incision extension and shorter operative time.
METHODS: A randomized clinical trial conducted at a tertiary University hospital between February 2017 and January 2019. Participants were randomly assigned to the classic head delivery technique (group I) or external Pop-out (EPO) technique (group II). The primary outcome was the incidence of unintended uterine incision extension during elective CS. A logistic regression model was utilized to examine the association between patient\'s characteristics and the occurrence of unintended uterine incision extension.
RESULTS: Participants in both groups (455 women in each group) had similar demographic characteristics. The EPO group had a significantly lower incidence of uterine incision extension than the classic group (p = 0.006). The operative time was significantly shorter in the EPO group (p = 0.000), which was also significantly easier than the classic technique (p = 0.001). The high body mass index (p = 0.004), previous delivery by CS (p = 0.010), high birth weight (p = 0.001) and the classic technique for head delivery (p = 0.002) were significant predictors for uterine incision tears.
CONCLUSIONS: EPO technique is an easy technique for fetal head delivery during elective CS with a lower risk of uterine incision extension and shorter operative time.
摘要：
目的：本研究旨在比较选择性剖宫产术（CS）中分娩胎儿头部的两种技术（外部弹出技术与经典技术）。还评估了选择性CS分娩的妇女在胎儿头部分娩期间与意外子宫切口扩大相关的潜在临床预测因素。
方法：2017年2月至2019年1月在三级大学医院进行的一项随机临床试验。参与者被随机分配到经典的头部递送技术（I组）或外部弹出（EPO）技术（II组）。主要结果是选择性CS期间子宫切口意外扩张的发生率。使用逻辑回归模型来检查患者的特征与意外子宫切口扩展的发生之间的关联。
结果：两组参与者（每组455名女性）具有相似的人口统计学特征。EPO组子宫切口扩张的发生率明显低于经典组(p=0.006)。EPO组手术时间明显缩短(p=0.000),这也比经典技术明显更容易（p=0.001）。高体重指数（p=0.004），CS上次交付(p=0.010)，高出生体重（p=0.001）和经典的头部分娩技术（p=0.002）是子宫切口撕裂的重要预测因素。
结论：EPO技术是选择性CS期间胎儿头部分娩的简便技术，子宫切口扩大的风险较低，手术时间较短。
方法：2017年2月至2019年1月在三级大学医院进行的一项随机临床试验。参与者被随机分配到经典的头部递送技术（I组）或外部弹出（EPO）技术（II组）。主要结果是选择性CS期间子宫切口意外扩张的发生率。使用逻辑回归模型来检查患者的特征与意外子宫切口扩展的发生之间的关联。
结果：两组参与者（每组455名女性）具有相似的人口统计学特征。EPO组子宫切口扩张的发生率明显低于经典组(p=0.006)。EPO组手术时间明显缩短(p=0.000),这也比经典技术明显更容易（p=0.001）。高体重指数（p=0.004），CS上次交付(p=0.010)，高出生体重（p=0.001）和经典的头部分娩技术（p=0.002）是子宫切口撕裂的重要预测因素。
结论：EPO技术是选择性CS期间胎儿头部分娩的简便技术，子宫切口扩大的风险较低，手术时间较短。
