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为死胎进行剖宫产——一个令人悲伤的现实。

Caesarean section for the dead baby--an unhappy reality.

作者信息

Mukherj Joydev, Kamilya Gourisankar, Bhattacharyya Subir Kumar

机构信息

Department of Obstetrics and Gynaecology, RG Kar Medical College, Kolkata.

出版信息

J Indian Med Assoc. 2007 Jun;105(6):316, 318-9.

Abstract

Caesarean section for the dead baby is sometimes still needed to prevent maternal complications. The objective of the study is to critically analyse the characteristics of the mother and indications for the operation in women who delivered stillbirths following caesarean section. The study period covered a 2 years span from January, 2003 to December, 2004. During this time 121 mothers (study group) underwent caesarean section for the dead baby representing 1.41% of all caesarean section operations done in the hospital. The study group was compared to the overall caesaren section done during the two years in relation to parity (parous 77.7% versus 45.7%), type of caesarean section (emergency 83.5% versus 69.8%) and timing of caesarean section within 12 hours of admission (74.4% versus 50.2%). Common indications in the study group included antepartum haemorrhage (31.4%), malpresentation (19.0%), postcaesarean pregnancies (16.5%), obstructed labour (15.7%), foetal distress (9.9%), second twin (4.1%) and eclampsia (3.3%). In some indications like obstructed labour and malpresentation, abdominal deliveries could be reduced by more destructive operations. The maternal reasons for resorting to caesarean section to save maternal lives are understandable. But caesaren section done for foetal distress was a disturbing revealation.

摘要

为死胎进行剖宫产有时仍有必要,以防止产妇出现并发症。本研究的目的是严格分析剖宫产分娩死胎的母亲的特征及手术指征。研究时间段为2003年1月至2004年12月,为期两年。在此期间,121名母亲(研究组)因死胎接受了剖宫产,占该医院所有剖宫产手术的1.41%。将研究组与这两年期间进行的所有剖宫产手术在产次(经产妇77.7%对45.7%)、剖宫产类型(急诊83.5%对69.8%)以及入院12小时内进行剖宫产的时间(74.4%对50.2%)方面进行了比较。研究组的常见指征包括产前出血(31.4%)、胎位异常(19.0%)、剖宫产后妊娠(16.5%)、产程梗阻(15.7%)、胎儿窘迫(9.9%)、第二产儿(4.1%)和子痫(3.3%)。在一些指征如产程梗阻和胎位异常方面,通过更具破坏性的手术可以减少经腹分娩。为挽救产妇生命而采取剖宫产的产妇原因是可以理解的。但因胎儿窘迫进行剖宫产是一个令人不安的发现。

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