...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of women’s health >Pelvic floor consequences of cesarean delivery on maternal request in women with a single birth: a cost-effectiveness analysis.
【24h】

Pelvic floor consequences of cesarean delivery on maternal request in women with a single birth: a cost-effectiveness analysis.

机译：剖腹产对单胎妇女产妇要求的盆底结果：成本效益分析。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

BACKGROUND: The potential benefit in preventing pelvic floor disorders (PFDs) is a frequently cited reason for requesting or performing cesarean delivery on maternal request (CDMR). However, for primigravid women without medical/obstetric indications, the lifetime cost-effectiveness of CDMR remains unknown, particularly with regard to lifelong pelvic floor consequences. Our objective was to assess the cost-effectiveness of CDMR in comparison to trial of labor (TOL) for primigravid women without medical/obstetric indications with a single childbirth over their lifetime, while explicitly accounting for the management of PFD throughout the lifetime. METHODS: We used Monte Carlo simulation of a decision model containing 249 chance events and 101 parameters depicting lifelong maternal and neonatal outcomes in the following domains: actual mode of delivery, emergency hysterectomy, transient maternal morbidity and mortality, perinatal morbidity and mortality, and the lifelong management of PFDs. Parameter estimates were obtained from published literature. The analysis was conducted from a societal perspective. All costs and quality-adjusted life-years (QALYs) were discounted to the present value at childbirth. RESULTS: The estimated mean cost and QALYs were Dollars 14,259 (95% confidence interval [CI] Dollars 8,964-Dollars 24,002) and 58.21 (95% CI 57.43-58.67) for CDMR and Dollars 13,283 (95% CI Dollars 7,861-Dollars 23,829) and 57.87 (95% CI 56.97-58.46) for TOL over the combined lifetime of the mother and the child. Parameters related to PFDs play an important role in determining cost and quality of life. CONCLUSIONS: When a woman without medical/obstetric indications has only one childbirth in her lifetime, cost-effectiveness analysis does not reveal a clearly preferable mode of delivery.
机译：背景：预防盆底疾病（PFD）的潜在好处是经常要求的或因产妇要求（CDMR）进行剖宫产的原因。但是，对于没有医学/产科适应症的初孕妇，CDMR的终生成本效益仍然未知，尤其是终生骨盆底后果方面。我们的目标是评估没有医学/产科指征且一生中只有一胎的初生妇女，将CDMR与分娩试验（TOL）进行比较，以明确成本效益，同时明确说明一生中对PFD的管理。方法：我们使用决策模型的蒙特卡罗模拟，该模型包含249个偶然事件和101个参数，这些参数描述了以下领域的终身孕产妇和新生儿结局：实际分娩方式，紧急子宫切除术，暂时性孕产妇发病率和死亡率，围产期发病率和死亡率，以及PFD的终身管理。参数估计是从已发表的文献中获得的。分析是从社会角度进行的。所有费用和质量调整生命年（QALY）均折算为分娩时的现值。结果：CDMR的估计平均成本和QALY为14,259美元（95％置信区间[CI] 8,964美元-24,002美元）和58.21美元（95％CI 57.43-58.67），13,283美元（95％CI 7,861美元-23,829美元）在母子总寿命中TOL为57.87（95％CI 56.97-58.46）。与PFD相关的参数在确定成本和生活质量方面起着重要作用。结论：当没有医学/产科适应症的妇女一生中只有一个分娩时，成本效益分析并没有显示出明显较好的分娩方式。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号