بررسی ارتباط نوع زایمان با پرولاپس ارگان‌های لگن در زنان: یک مطالعه مقطعی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دکتری تخصصی بهداشت باروری، مرکز تحقیقات مراقبتهای پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران. استادیار گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 مربی گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

4 کارشناس ارشد مامایی، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

5 دانشیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

6 کارشناس ارشد اپیدمیولوژی، مرکز تحقیقات علوم مدیریت و اقتصاد سلامت، پژوهشکده مدیریت سلامت، دانشگاه علوم پزشکی ایران، تهران، ایران.

چکیده

مقدمه: پرولاپس ارگان­های لگن، یکی از اختلالات شایع زنان است. مطالعات ضدونقیضی در زمینه ارتباط نوع زایمان با پرولاپس ارگان‌های لگن وجود دارد، لذا مطالعه حاضر با هدف تعیین ارتباط نوع زایمان با پرولاپس ارگان‌های لگن در زنان انجام شد.
روشکار: این مطالعه روش مقطعی در سال 98-1397 بر روی 250 زن واجد شرایط مراجعه‌کننده به مراکز بهداشتی- درمانی مشهد انجام شد. ابزار گردآوری داده­ها شامل پرسشنامه محقق‌ساخته (مشخصات دموگرافیک- مامایی و فرم ثبت مشاهدات و معاینات)، والو واژینال و هیسترومتر بدون انحنا، اسپچولای مدرج و اسپکلوم بود. معاینات لازم جهت تعیین پرولاپس ارگان‌های لگن و همچنین شدت و نوع آن انجام شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 16) و آزمون­های آماری من‌ویتنی، کای دو و ضریب همبستگی اسپیرمن انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافتهها: بر اساس نتایج رگرسیون تک‌متغیره، در زنان با زایمان طبیعی نسبت به سزارین، شانس داشتن سیستوسل درجه 2 نسبت به صفر 67/23 برابر، رکتوسل درجه 2 نسبت به صفر 13/31، آنتروسل درجه 2 نسبت به صفر 21/12 و پرولاپس رحم درجه 2 نسبت به صفر 38/7 برابر بود (001/0>p). از نظر فراوانی انواع پرولاپس، در گروه زایمان طبیعی سیستوسل درجه 1 (6/54%)، پرولاپس رحم درجه 1 (52%) و رکتوسل درجه 1 (4/46%) بیشترین فراوانی را داشتند و در گروه زایمان سزارین پرولاپس رحم درجه 1 (6/57%)، سیستوسل درجه 1 (52%) و رکتوسل درجه 1 (0/36%) شایع‌تر بودند.
نتیجهگیری: در زنان با زایمان طبیعی، فراوانی و شدت ایجاد پرولاپس ارگان‌های لگن بیشتر از زایمان سزارین است.

کلیدواژه‌ها


عنوان مقاله [English]

The relationship between mode of delivery and pelvic organ prolapse in women: A cross-sectional study

نویسندگان [English]

  • Maryam Moradi 1
  • Azin Niazi 2
  • Bibi Sedigheh Shariat Moghani 3
  • Fatemeh Mohammadzadeh 4
  • Maliheh Afiat 5
  • Ehsan Mazloumi 6
1 PhD in Reproductive Health, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Assistant Professor, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
2 M.Sc. of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Instructor, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
4 M.Sc. of Midwifery, Student Research Committee, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
5 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
6 M.Sc. in Epidemiology, Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Pelvic organs prolapse is one of the most common disorders in women. There are conflicting studies on the relationship between mode of delivery and pelvic organ prolapse. Therefore, this study was performed with aim to determine the relationship between mode of delivery and pelvic organ prolapse in women.
Methods: This cross-sectional study was performed on 250 women referring to the health-treatment centers in Mashhad. Data collection tools included the researcher-made questionnaire (demographic and midwifery information and the form of recording observations and examinations). The necessary examinations were performed to determine the prolapse of pelvic organs as well as its severity and type. Data were analyzed using SPSS software (version 16) and Mann-Whitney, Chi-square and Spearman correlation coefficient tests. P <0.05 was considered statistically significant.
Results: Based on univariate regression results, in women with normal delivery compared to cesarean section, the chance of having a degree 2 cystocell compared to zero is 23.67 times, the chance of having a second degree rectus cell to zero is 31.13 times, the degree 2 anterocell to zero is 12.21 times and degree 2 uterine prolapse to zero is 7.38 times (p <0.001). In terms of frequency of prolapse, in the normal delivery group, grade 1 cystocele (54.4%), grade 1 uterine prolapse (52%) and grade 1 rectocele (46.4%) had the highest frequency, and in the cesarean delivery group, grade 1 uterine prolapse (57.6%), grade 1 cystocele (52%) and grade 1 rectocele (36.0%) were more common.
Conclusion: The frequency and severity of pelvic organ prolapse was higher in women with normal delivery than cesarean section.

کلیدواژه‌ها [English]

  • Cesarean section
  • Delivery
  • Pelvic floor
  • Pelvic organ prolapse
  • vaginal
  • Women
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