荷兰臀位选择性剖宫产术后的孕产妇死亡情况。

Maternal deaths after elective cesarean section for breech presentation in the Netherlands.

作者信息

Schutte Joke M, Steegers Eric A P, Santema Job G, Schuitemaker Nico W E, van Roosmalen Jos

机构信息

University Medical Center, Groningen, The Netherlands.

出版信息

Acta Obstet Gynecol Scand. 2007;86(2):240-3. doi: 10.1080/00016340601104054.

DOI:10.1080/00016340601104054

PMID:17364290

Abstract

BACKGROUND AND METHODS

The cesarean section rate for term singleton breech babies in the Netherlands rose from 57 to 81% after the Term Breech Trial in 2000. The Dutch Maternal Mortality Committee registered and evaluated maternal mortality due to elective cesarean section for breech.

RESULTS

Four maternal deaths after elective cesarean section for breech presentation, from 2000 to 2002 inclusive, were registered, 7% of total direct maternal mortality in that period. Two women died due to massive pulmonary embolism, both were obese, and thromboprophylaxis was not adjusted to their weight. The other two women died from sepsis, one had not receive perioperative prophylactic antibiotics. The case fatality rate for elective cesarean section for breech presentation was 0.47/1,000 operations. No death after emergency cesarean section for breech presentation was registered at the committee.

CONCLUSIONS

Elective cesarean section does not guarantee the improved outcome of the child, but may increase risks for the mother, compared to vaginal delivery.

摘要

背景与方法

在2000年臀位产试验后，荷兰足月单胎臀位婴儿的剖宫产率从57%升至81%。荷兰孕产妇死亡委员会对因选择性剖宫产分娩臀位婴儿导致的孕产妇死亡进行了登记和评估。

结果

登记了2000年至2002年（含）期间4例因选择性剖宫产分娩臀位婴儿导致的孕产妇死亡，占该时期孕产妇直接死亡总数的7%。两名女性死于大面积肺栓塞，两人均肥胖，且血栓预防措施未根据其体重进行调整。另外两名女性死于败血症，其中一人未接受围手术期预防性抗生素治疗。选择性剖宫产分娩臀位婴儿的病死率为0.47/1000例手术。委员会未登记因急诊剖宫产分娩臀位婴儿导致的死亡病例。