Episode Transcript
Dr. Miller: When should your birth be induced? We're going to talk about that next on Scope Radio.
Announcer: 向大发娱乐的专家大发娱乐提供有关您今天面临的最大健康问题的深入信息. The Specialists with Dr. Tom Miller is on The Scope.
Dr. Miller: Hi, I'm here with Howard Sharp, 他是犹他大学产科和基因生态学教授. Howard, what does it mean when a woman is induced?
Howard: We're talking about labor induction. That would be starting a patient into labor artificially. Most women will eventually go into labor, in fact if you wait long enough, over 90% are just to go on their own. 但在过去的几十年里，大发娱乐已经养成了一种习惯，那就是开始治疗病人. 有时大发娱乐选择性地开始，有时大发娱乐因为有指示而开始, there's a problem, maybe there's high blood pressure or preeclampsia.
Dr. Miller: So, 一种是由于健康原因或防止医疗结果而开始进行诱导.
Howard: Yes. That will be called a medically indicated induction. But there are a lot of elective inductions that have gone on.
Dr. Miller: 现在这个国家有更多的选择性或医学诱导吗?
Howard: That's a good question. It probably varies from site to site. 大发娱乐犹他大学没有那么多选拔赛, 但大发娱乐确实做了，而且做得非常仔细，有很多咨询.
Dr. Miller: 我想你们可能担心的一个问题是可能有比需要的更多的诱导?
Howard: I think so. It's interesting if you look at the... 比如60年代的剖腹产率，大约5%的女性做了剖腹产. Last year it was about 33%. So, something happened on the way to the 2000s. I think maybe there is a little bit of medic-legal worry, certainly inductions became a little but more popular, we had access to Oxytocin.
Dr. Miller: That's one of the hormones that induces the labor.
Howard: Exactly.
Dr. Miller: Starts labor.
Howard: 很多事情都发生了变化，加上婴儿越来越大. Sometimes baby's just a little bit bigger than the pelvis. 但我认为很多原因增加的剖腹产率是不必要的. 这就是大发娱乐真正想要关注的让它更低.
Dr. Miller: 一个女人说她不想被选择性诱导，这公平吗? Is that part of the conversation?
Howard: Yes. In fact ideally, 我想大发娱乐大多数人都会同意，如果一个女人可以自己分娩，这是理想的，这是大发娱乐真正喜欢的.
Dr. Miller: 为什么医学界在择期引产这个问题上存在分歧? 听起来，人们对诱导预防疾病或医疗并发症的看法并没有多大分歧, 但听起来在选拔赛上可能存在一些分歧.
Howard: Yes, there is some disagreement. 我认为在选任方面存在一些问题, 有一个方便的因素，有时对医生来说更方便, sometimes it's more convenient for the patients, their families. 所以大发娱乐需要权衡剖腹产的风险.
I think most people, 如果你认为剖腹产的风险更高因为你在做择期引产, most people would say, "Well okay, hold off a little bit.“话虽如此，这并不意味着所有的选择性诱导都是不好的. 如果你有一个合适的病人，剖宫产率真的不会增加太多.
Dr. Miller: If a woman has a failed induction, is that a possibility?
Howard: Yes.
Dr. Miller: 这种情况发生的频率有多高，你被引产了，但最后却没有足月分娩?
Howard: That is more common in a first time mom. The first time around, 大发娱乐真的鼓励病人在医学上需要之前不要进行诱导. 如果她们有医疗问题或者她们已经到了孕龄, whether that's 41, 42 weeks there is going to be a higher risk of still birth. Or at some point if the percentage is not working as well, 如果你等待的时间过长，剖腹产的风险会稍微高一些.
Dr. Miller: 听起来，医学引产需要听取产科医生的建议，而选择性引产对于初次分娩的母亲来说无疑是一个更大的问题, probably to be avoided electively. In general, 与你的医生讨论在第二足月或更长足月分娩中选择性引产的使用.
Howard: I think it really does require a conversation. 例如，如果这是她们的第二个或第三个孩子，她们的第一个或第二个孩子是顺产的，她们的宫颈已经准备好了, 大发娱乐实际上有分数来衡量子宫颈的准备程度. 只要怀孕至少39周，这是一个合理的讨论. 其中一个问题是在婴儿准备好之前就引产了. 大发娱乐在美国遇到了一点麻烦在39周之前做选择性引产婴儿最终会在新生儿重症监护病房这是一个可怕的结果. 有很多事情需要考虑，值得讨论一下.
Dr. Miller: 你认为在分娩前去产科医生办公室的时候讨论是否应该尽早进行?
Howard: I do. 我觉得一旦你快要分娩了，有些人就会对怀孕感到厌倦. I'm a guy, so obvious I've never done this but
Dr. Miller: I think as you look, you are. I get that.
Howard:
but I can only imagine it's uncomfortable. 如果有人期望被诱导或者如果他们已经有了，然后你告诉他们不是这样, that's a little bit tough to take.
Dr. Miller: In your practice or your colleagues practice, 你在早期和病人讨论时通常会从你的角度提出这个问题吗? 一般来说，如果可能的话，你不希望进行选择性诱导.
Howard: Right. 大发娱乐通常至少在妊娠晚期的早期提出这个问题.
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