臨床婦人科産科75巻7号

2021年07月発行

今月の臨床 専攻医必携！ 術中・術後トラブル対処法―予期せぬ合併症で慌てないために

産科編

器械分娩

著者： 藤田太輔¹ 大道正英¹

所属機関： ¹大阪医科薬科大学産婦人科教室

ページ範囲：P.627 - P.634

文献概要

●器械分娩の適応についてはガイドラインを参照し，方法については上級医から適切なトレーニングを受けて日々修練が必要である．

●器械分娩の母児のリスクについて理解し，それらのリスクに対応した管理を行うことが重要である．

参考文献

1）Martin JA, et al : Births : final data for 2017. Natl Vital Stat Rep 67 : 1, 2018

2）日本産科婦人科学会，他（編）：産婦人科診療ガイドライン―産科編2020．CQ406-1「吸引・鉗子娩出術の適応と要約，および実施時の注意点は？」．日本産科婦人科学会事務局，2020

3）Tsakiridis I, et al : Operative vaginal delivery : a review of four national guidelines. J Perinat Med 26 48 : 189-198, 2020

4）Murphy DJ, et al ; Royal College of Obstetricians and Gynaecologist : Green-top Guideline No. 26 Assisted Vaginal Birth. BJOG127 : e70-e112, 2020

5）The Royal Australian and New Zealand College of Obstetricians and Gynaecologists : Instrumental vaginal birth（C-Obs 16）.

6）Hobson S, et al : No. 381-Assisted vaginal birth. J Obstet Gynaecol Can 41 : 870-882, 2019

7）Operative vaginal birth : ACOG Practice Bulletin, Number 219. Obstet Gynecol 135 : e149-e159, 2020

8）Johanson RB, et al : Vacuum extraction versus forceps for assisted vaginal delivery. Cochrane Database Syst Rev （2） : CD000224, 2000

9）Murphy DJ, et al : Cohort study of the decision to delivery interval and neonatal outcome for emergency operative vaginal delivery. Am J Obstet Gynecol 196 : 145.e1-145.e7, 2007

10）Johanson R, et al : Soft versus rigid vacuum extractor cups for assisted vaginal delivery. Cochrane Database Syst Rev（2） : CD000446, 2000

11）Landy HJ, et al : Characteristics associated with severe perineal and cervical lacerations during vaginal delivery Obstet Gynecol 117 : 627-635, 2011

12）Sagi-Dain L, et al : Morbidity associated with episiotomy in vacuum delivery : a systematic review and meta-analysis. BJOG 122 : 1073-1081, 2015

13）Lund NS, et al : Episiotomy in vacuum-assisted delivery affects the risk of obstetric anal sphincter injury : a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 207 : 193-199, 2016

14）Melamed N, et al : Intrapartum cervical lacerations : characteristics, risk factors, and effects on subsequent pregnancies. Am J Obstet Gynecol 200 : 388.e1-388.e4, 2009

15）Driessen M, et al : Postpartum hemorrhage resulting from uterine atony after vaginal delivery : factors associated with severity. Obstet Gynecol 117 : 21-31, 2011

16）Liabsuetrakul T, et al : Antibiotic prophylaxis for operative vaginal delivery. Cochrane Database Syst Rev（3） : CD004455, 2004

17）Knight M, et al ; ANODE collaborative group : Prophylactic antibiotics in the prevention of infection after operativevaginal delivery（ANODE） : a multicentre randomised controlled trial. Lancet 393 : 2395-2403, 2019

18）Handa VL, et al : Pelvic floor disorders after vaginal birth : effect of episiotomy, perineal laceration, and operative birth. Obstet Gynecol 119 : 233-239, 2012

19）Boo NY, et al : Risk factors associated with subaponeurotic haemorrhage in full-term infants exposed to vacuum extraction. BJOG 112 : 1516-1521, 2005

20）Davis DJ : Neonatal subgaleal hemorrhage : diagnosis and management. CMAJ 164 : 1452-1453, 2001

21）Simonson C, et al : Neonatal complications of vacuum-assisted delivery. Obstet Gynecol 109 : 626-633, 2007

22）Dupuis O, et al : Comparison of “instrument-associated” and “spontaneous” obstetric depressed skull fractures in a cohort of 68 neonates. Am J Obstet Gynecol 192 : 165-170, 2005

23）Towner D, et al : Effect of mode of delivery in nulliparous women on neonatal intracranial injury. N Engl J Med 341 : 1709-1714, 1999