OUTCOMES OF SPONTANEOUS BIRTHS IN HEALTHY FIRST AND MULTIPLE MOTHERS

Ishodi porođaja gdje su majka i dijete dobrog općeg stanja uz najmanje korištenja intervencija pokazatelj je kvalitete u zdravstvenoj skrbi žena neovisno o broju poroda. Prema navedenim istraživanjima veće iskustvo zadovoljstva nakon porođaja povećava vjerojatnost ponovnog rađanja. Svrha ovog rada je prikazati metode kliničkog pristupa zdravim rodiljama sa spontano započetim porođajima. Prikazati razlike u odabiru intervencija u porođaju, korištenju lijekova i metodi dovršenja poroda kod spontano započetih porođaja zdravih prvorotkinja i višerotkinja. Istraživanje je provedeno u Klinici za ženske bolesti i porode KBC-a Zagreb prikupljanjem retrospektivnih podatka o ishodima porođaja na uzorku ukupnog broja zdravih prvorotkinja i višerotkinja (30%) prvog šestomjesečnog razdoblja 2021. godine. Podaci su prikupljeni iz kliničke baze podataka o ishodima porođaja. Prikazani rezultati o ishodima porođaja zdravih rodilja sa spontanim početkom porođaja prikazuju visoku stopu vaginalnih poroda (97%), te visoke ocjene vitalnosti novorođenčadi (Apgar score 9,97 i 9,99 nakon prve i pete minute) za sve skupine zdravih rodilja neovisno o paritetu odnosno rednom broju porođaja. Prikazana je niska stopa poroda dovršenih carskim rezom (3%), vaginalnih poroda uz vakuum (1%) i epiziotomija (19%) te se u skadu s preporukama mogu okarakterizirati kao normalni porođaji sa niskim rizicima. Prvorotkinje će imati više epiziotomija i amniotomija tijekom poroda od višerotkinja. Ishod porođaja carskim rezom i porođaja uz vakuum su češći kod prvorotkinja. Korištenje epiduralne analgezije u porodu je češće kod prvorotkinja u odnosu na višerotkinje. Višerotkinje češće dobivaju opijate. Kod zdravih rodilja sa spontano započetim porođajem djeca neovisno o paritetu imaju ukupnu dobru ocjenu vitalnosti (Apgar score).Outcomes of childbirth where the mother and child are in good general condition with the least use of interventions is an indicator of quality in women's health care regardless of the number of births. According to these studies, a greater experience of postpartum pleasure increases the likelihood of recurrence. The purpose of this paper is to present a method of clinical approach to healthy mothers with spontaneous labor. Show the differences in the choice of intervention in childbirth, the drugs used and the method of completion of childbirth in spontaneously initiated births of healthy nuliparous and multiparous. The research was conducted at the Clinic for Women's Diseases and Obstetrics of the University Hospital Center Zagreb by collecting retrospective data on delivery outcomes on a sample of the total number (healthy nuliparous and multiparous) (30%) of the first six-month period in 2021. The presented results on the outcomes of delivery of healthy mothers with spontaneous onset of labor show a high rate of vaginal birth (95%), and high scores of newborn vitality (Apgar score 9.97 and 9.99 after the first and fifth minutes) for all groups of healthy mothers regardless of parity or ordinal number of births. The low rate of births completed by cesarean section (3%), vaginal births with vacuum (1%) and episiotomy (19%) are shown and, in accordance with the recommendations, can be characterized as normal births with low risks. Nuliparous will have more episiotomies and amniotomies during childbirth than multiparous. The outcome of cesarean delivery and vacuum delivery are more common in nuliparous. The use of epidural analgesia in childbirth is more common in nuliparous than in multiparous. Multipartum women are more likely to receive opiates. In healthy mothers with spontaneous labor, children, regardless of parity, have an overall good vitality score (Apgar score)