618 KB47 KB199420252014Poat, AngelaPrelec, AnitaVerdenik, Ivanštevilka:3letnik:48str. 166-176ISSN:1318-2951COBISSID:520235289URN:URN:NBN:SI:doc-IXENYTJQenZbornica zdravstvene negeObzornik zdravstvene negechildbirthlabourlow riskmedical interventionsmedicinske intervencijenizko tveganjeperinatal outcomesperinatalni izidiporodA comparison of frequency of medical interventions and birth outcomes between the midwife led unit and the obstetric unit in low-risk primiparous women| Primerjava pojavnosti medicinskih intervencij in porodnih izidov pri nizkorizičnih prvorodnicah v samostojni babiški enoti in porodni enoti|Introduction: The purpose of this national research was to compare birth, maternal and newborn outcomes in the midwife led unit and the obstetric unit to ascertain whether a midwife led unit reduced medicalisation of childbirth. Methods: A prospective observational case-control study was carried out in Ljubljana Maternity Hospital in the period May - August 2013. The sample comprised 497 labouring women; 154 who attended the midwife led and 343 who attended in the obstetric unit, both matching the same inclusion criteria: low risk primiparous; singleton term pregnancies, normal foetal heart beat, cephalic presentation; spontaneous onset of labour. The primary outcome was the caesarean section rate. Chi-square test was used to compare medical interventions and birth outcomes. Results: Women in the midwife led unit had statistically significant higher spontaneous vaginal births (p < 0.001), less augmentation with oxytocin (p < 0.001), less use of analgesia (p < 0.001), less operative vaginal deliveries (p < 0.001) and less caesarean sections (p < 0.001), lower rates of episiotomy (p < 0.001) and more exclusively breastfed (p = 0.002). Discussion and conclusion: These significant findings showed that in the midwife led unit fewer medical interventions were used. For generalisation of the findings more similar studies in Slovenia are neededUvod: Namen nacionalne raziskave je bila primerjava porodnih izidov ter izidov pri materah in novorojenčkih v samostojni babiški enoti in porodni enoti ter tako preveriti, ali so porodi v samostojni babiški enoti manj medikalizirani. Metode: Prospektivna opazovalna raziskava primerov s kontrolami je bila izvedena med majem in avgustom 2013. V raziskavi je sodelovalo 497 žensk, 154 žensk je rodilo v samostojni babiški enoti in 343 žensk v porodni enoti. Obe skupini žensk sta izpolnjevali enak vstopni kriterij: prvorodnice brez prisotnih dejavnikov tveganja, ob porodnem terminu, z enim plodom v glavični vstavi, normalno plodovo frekvenco srca in spontanim začetkom poroda. Primarni izid je bil delež carskih rezov. Za primerjavo medicinskih intervencij in porodnih izidov v obeh skupinah je bil uporabljen test hi-kvadrat. Rezultati: Ženske, ki so rodile v samostojni babiški enoti, so imele statistično pomembno več spontanih vaginalnih porodov (p < 0.001), manj pospeševanj z oksitocinom (p < 0.001), manjšo uporabo analgetikov (p < 0.001), manj operativnih vaginalnih porodov (p < 0.001) in carskih rezov (p < 0.001), manj epiziotomij (p < 0.001) in več polnega dojenja (p = 0.002). Diskusija in zaključek: V samostojni babiški enoti je bilo uporabljenih manj medicinskih intervencij. Za generalizacijo zaključkov te študije bi bile potrebne nadaljnje raziskave v SlovenijiTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaZbornica zdravstvene in babiške nege Slovenije - Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije