Lee Young Mi, D'Alton Mary E
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA.
Clin Perinatol. 2008 Sep;35(3):505-18, x. doi: 10.1016/j.clp.2008.07.006.
Mothers should be counseled that the most concerning risks related to maternal request cesarean delivery are neonatal respiratory morbidity and those that may affect the mother's future reproductive health, including life-threatening conditions, such as placenta accreta. The literature suggests that overall risks of maternal complications with cesarean delivery on maternal request are slightly lower than a trial of vaginal delivery and are primarily driven by the avoidance of unplanned or emergent cesarean deliveries and their associated increased rate of complications. When addressing risks and benefits with patients, there are three areas of importance. First, the risks for neonatal respiratory morbidity and abnormal placentation with future pregnancies should be emphasized. Secondly, there are many areas on which studies are lacking. Finally, numerous factors can alter the risks and benefits--such as culture, maternal obesity, and provider background--and should be acknowledged.
应向母亲们提供咨询，告知她们与产妇要求剖宫产相关的最令人担忧的风险是新生儿呼吸疾病，以及那些可能影响母亲未来生殖健康的风险，包括危及生命的情况，如胎盘植入。文献表明，因产妇要求进行剖宫产的产妇并发症总体风险略低于阴道试产，主要原因是避免了计划外或紧急剖宫产及其相关的并发症发生率增加。在与患者讨论风险和益处时，有三个重要方面。首先，应强调新生儿呼吸疾病和未来妊娠胎盘异常的风险。其次，有许多领域缺乏研究。最后，许多因素会改变风险和益处，如文化、产妇肥胖和医疗服务提供者背景等，都应予以承认。
