Kessous Roy, Danor Daniela, Weintraub Y Adi, Wiznitzer Arnon, Sergienko Ruslan, Ohel Iris, Sheiner Eyal
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
J Matern Fetal Neonatal Med. 2012 Nov;25(11):2167-70. doi: 10.3109/14767058.2012.668978. Epub 2012 Apr 24.
To investigate risk factors for relaparotomy after cesarean section (CS).
A retrospective case-control study comparing all CS that were complicated with relaparotomy to cesarean deliveries without this complication.
Relaparotomy complicated 0.23% (n=80) of CS during the study period (n=34,389). Independent risk factors for relaparotomy following CS from a multivariable logistic regression model were post partum hemorrhage, cervical tears, placenta previa, uterine rupture, placental abruption, severe preeclampsia and previous CS. Most women (51.2%) underwent relaparotomy during the first 24 h after CS. The leading causes for relaparotomy was bleeding (70%) and burst abdomen (8.8%). Hysterectomy was performed in 31.3% of the patients.
Risk factors for relaparotomy after CS are previous CS, severe preeclampsia, placenta previa, uterine rupture, placental abruption, cervical tear and PPH. Experienced obstetricians should be involved in such cases and the possibility for complications including relaparotomy should be emphasized.
探讨剖宫产术后再次剖腹手术的危险因素。
一项回顾性病例对照研究，比较所有并发再次剖腹手术的剖宫产与未发生该并发症的剖宫产分娩情况。
在研究期间（n = 34389），0.23%（n = 80）的剖宫产并发再次剖腹手术。多变量逻辑回归模型显示，剖宫产术后再次剖腹手术的独立危险因素包括产后出血、宫颈撕裂、前置胎盘、子宫破裂、胎盘早剥、重度子痫前期和既往剖宫产史。大多数女性（51.2%）在剖宫产术后24小时内接受了再次剖腹手术。再次剖腹手术的主要原因是出血（70%）和腹部切口裂开（8.8%）。31.3%的患者接受了子宫切除术。
剖宫产术后再次剖腹手术的危险因素包括既往剖宫产史、重度子痫前期、前置胎盘、子宫破裂、胎盘早剥、宫颈撕裂和产后出血。此类病例应由经验丰富的产科医生处理，并应强调包括再次剖腹手术在内的并发症发生可能性。
