Gordon Adrienne, McKechnie Elizabeth Jane, Jeffery Heather
Department of Neonatal Medicine, Royal Prince Alfred Hospital, Sydney, Australia.
Am J Obstet Gynecol. 2005 Sep;193(3 Pt 1):599-605. doi: 10.1016/j.ajog.2005.06.013.
This study was undertaken to determine the incidence and type of resuscitation required for infants delivered by both elective and emergency cesarean section relative to spontaneous vaginal delivery.
A hospital-based cohort study from 1990 to 2002. Information was extracted from a prospectively collected database on term (>/=37 weeks) singleton infants delivered by cesarean section and spontaneous vaginal delivery. Analysis was performed on type of cesarean section, type of anesthetic, fetal presentation, and evidence of fetal distress. Outcomes assessed were resuscitation and Apgar scores.
There were 44,938 eligible deliveries. There was no significant difference in need for resuscitation between infants born by elective cesarean section under regional anesthetic compared with spontaneous vaginal delivery (chi(2)=0.998; df=1; P=.318). General anesthesia, fetal distress, and noncephalic presentation increase the need for resuscitation.
An advanced skills practitioner does not need to be present at elective cesarean sections under regional anesthesia provided there are no additional risk factors.
本研究旨在确定择期剖宫产和急诊剖宫产分娩的婴儿相对于自然阴道分娩所需复苏的发生率和类型。
一项基于医院的队列研究，时间跨度为1990年至2002年。信息从一个前瞻性收集的数据库中提取，该数据库涉及剖宫产和自然阴道分娩的足月（≥37周）单胎婴儿。对剖宫产类型、麻醉类型、胎儿先露情况和胎儿窘迫证据进行了分析。评估的结果是复苏情况和阿氏评分。
共有44938例符合条件的分娩。与自然阴道分娩相比，在区域麻醉下择期剖宫产出生的婴儿在复苏需求方面没有显著差异（χ²=0.998；自由度=1；P=0.318）。全身麻醉、胎儿窘迫和非头位先露会增加复苏需求。
如果没有其他风险因素，在区域麻醉下进行择期剖宫产时无需高级技能从业者在场。
