北京协和医院再次剖宫产的妊娠结局

Pregnancy outcomes of repeat cesarean section in Peking Union Medical College Hospital.

作者信息

Ma Liang-Kun, Liu Na, Bian Xu-Ming, Teng Li-Rong, Qi Hong, Gong Xiao-Ming, Liu Jun-Tao, Yang Jian-Qiu

机构信息

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.

出版信息

Chin Med Sci J. 2009 Sep;24(3):147-50. doi: 10.1016/s1001-9294(09)60079-1.

DOI:10.1016/s1001-9294(09)60079-1

PMID:19848314

Abstract

OBJECTIVE

To evaluate the effect of elective repeat cesarean section on the maternal and neonatal outcomes.

METHODS

A retrospective clinic- and hospital-based survey was designed for comparing the maternal and neonatal outcomes of elective repeat cesarean section [RCS group (one previous cesarean section) and MRCS group (two or more previous cesarean sections)] and primary cesarean section (FCS group) at Peking Union Medical College Hospital from January 1998 to December 2007.

RESULTS

The incidence of repeat cesarean section increased from 1.26% to 7.32%. The mean gestational age at delivery in RCS group (38.1+/-1.8 weeks) and MRCS group (37.3+/-2.5 weeks) were significantly shorter than that in FCS group (38.9+/-2.1 weeks, all P<0.01). The incidence of complication was 33.8% and 33.3% in RCS group and MRCS group respectively, and was significantly higher than that in FCS group (7.9%, P<0.05). Dense adhesion (13.5% vs. 0.4%, OR=7.156, 95% CI: 1.7-30.7, P<0.01) and uterine rupture (1.0% vs. 0, P<0.05) were commoner in RCS group compared with FCS group. Neonatal morbidity was similar among three groups (P>0.05).

CONCLUSIONS

Repeat cesarean section is associated with more complicated surgery technique and increased frequency of maternal morbidity. However, the incidence of neonatal morbidity is similar to primary cesarean section.

摘要

目的

评估择期再次剖宫产对母婴结局的影响。

方法

设计一项基于临床和医院的回顾性调查，比较1998年1月至2007年12月在北京协和医院择期再次剖宫产（RCS组，有一次既往剖宫产史）、多次择期再次剖宫产（MRCS组，有两次或更多次既往剖宫产史）和首次剖宫产（FCS组）的母婴结局。

结果

再次剖宫产的发生率从1.26%上升至7.32%。RCS组（38.1±1.8周）和MRCS组（37.3±2.5周）的平均分娩孕周显著短于FCS组（38.9±2.1周，均P<0.01）。RCS组和MRCS组的并发症发生率分别为33.8%和33.3%，显著高于FCS组（7.9%，P<0.05）。与FCS组相比，RCS组致密粘连（13.5%对0.4%，OR=7.156，95%CI：1.7 - 30.7，P<0.01）和子宫破裂（1.0%对0，P<0.05）更为常见。三组间新生儿发病率相似（P>0.05）。