阴道助产安全重塑之决策评估、技巧创新与风险管控OA

Globally,the cesarean section rate continues to rise,which is expected to reach 28.5％by 2030.Meanwhile,the rate of assisted vaginal delivery is on the decline,and there are significant regional differences.This results from the combined effects of various factors including medical technology,social concepts,and medical environments.Under appropriate indications,skilled and safe assisted vaginal delivery remains an effective measure for saving lives,as it can accelerate the delivery process and avoid or reduce the short and long-term complications associated with second-stage cesarean sections.How to enhance the skills of obstetricians in assisted vaginal birth while ensuring safety has become an important issue that needs urgent attention and resolution in the field of obstetrics.This article reviews the current best evidence on assisted vaginal delivery and proposes the following good recommendations on practice,including:the prerequisites for assisted vaginal delivery,high-risk factors,the feasibility of difficult delivery procedures,technological innovations,standard operating procedures,training of operators' qualifications,and the use of a safety checklist for assisted vaginal delivery to reduce the risk of complications,etc.It is suggested that all obstetric healthcare providers,including obstetricians and midwives at all levels,should receive training and possess the team collaboration ability to perform assisted vaginal deliveries(including forceps delivery and vacuum extraction),which will help slow down the rising trend of cesarean section rate,and thus decrease the adverse outcomes caused by inappropriate delivery modes.