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先前的剖宫产术与未来妊娠中产妇并发症和不良新生儿结局的风险。

Previous cesarean section and the risk of postpartum maternal complications and adverse neonatal outcomes in future pregnancies.

机构信息

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine University of California Irvine, Orange, CA, USA.

出版信息

J Perinatol. 2009 Nov;29(11):726-30. doi: 10.1038/jp.2009.108. Epub 2009 Jul 23.

Abstract

OBJECTIVE

To assess maternal postpartum and neonatal outcomes associated with previous method of delivery.

STUDY DESIGN

We analyzed prospectively collected maternal and neonatal data from July 2002 to December 2003. Data were collected from dedicated perinatal database and neonatal database from discharge and procedure codes. Groups were: (i) multiparous, prior vaginal delivery (VD), and (ii) multiparous, prior cesarean (CS). This group was subdivided by subsequent pregnancy trial or no trial of labor (No TOL). Results were compared with chi (2)-analysis; significance P<0.05.

RESULTS

There were 17 406 births. Prior CS patients without trial of labor (TOL) required more blood transfusions, intensive care unit admissions and hospital readmissions than women with a prior VD. Prior CS patients with TOL required more aminoglycosides for postpartum infection. Term neonates of (CS) mothers without a TOL were more likely to have prolonged hospitalization and require ventilatory support.

CONCLUSIONS

In their subsequent delivery, women with a prior CS delivery are at significant risks for postpartum maternal and neonatal morbidities compared with parous patients who experienced a prior VD.

摘要

目的

评估与既往分娩方式相关的产妇产后和新生儿结局。

研究设计

我们前瞻性地分析了 2002 年 7 月至 2003 年 12 月期间收集的产妇和新生儿数据。数据来自专门的围产期数据库和从出院和手术代码中收集的新生儿数据库。组分为:(i)多产妇,既往阴道分娩(VD),和(ii)多产妇,既往剖宫产(CS)。该组根据随后的分娩试验或未进行分娩试验(无 TOL)进一步细分。结果用卡方(2)检验进行比较;显著性 P<0.05。

结果

共有 17406 例分娩。无 TOL 的既往 CS 患者需要更多的输血、重症监护病房入院和医院再入院,比有既往 VD 的患者多。有 TOL 的既往 CS 患者因产后感染需要更多的氨基糖苷类药物。无 TOL 的(CS)母亲的足月新生儿更有可能住院时间延长并需要通气支持。

结论

与经历过既往 VD 的多产妇相比,既往 CS 分娩的妇女在随后的分娩中面临着显著的产后母婴发病率风险。

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