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非产科产前手术后的产妇术后并发症。

Maternal postoperative complications after nonobstetric antenatal surgery.

作者信息

Erekson Elisabeth A, Brousseau E Christine, Dick-Biascoechea Madeline A, Ciarleglio Maria M, Lockwood Charles J, Pettker Christian M

机构信息

Yale University School of Medicine, Department of Obstetrics, Gynecology, & Reproductive Sciences, New Haven, CT 06520–8063, USA.

出版信息

J Matern Fetal Neonatal Med. 2012 Dec;25(12):2639-44. doi: 10.3109/14767058.2012.704445. Epub 2012 Jul 11.

Abstract

OBJECTIVE

Our primary objective is to estimate the occurrence of major maternal 30 day postoperative complications after nonobstetric antenatal surgery.

METHODS

We analyzed the 2005-2009 data files from the American College of Surgeons National Surgical Quality Improvement Program to assess outcomes for pregnant women undergoing nonobstetric antenatal surgery during any trimester of pregnancy as classified by CPT-4 codes. t Tests, χ(2), logistic regression and other tests were used to calculate composite 30-day major postoperative complications and associations of preoperative predictors with 30 day postoperative morbidity.

RESULTS

The most common nonobstetric antenatal surgical procedure among the 1969 included women was appendectomy (44.0%). The prevalence of composite 30-day major postoperative complications was 5.8% (n = 115). This included (not exclusive categories): return to the surgical operating room within 30 days of surgery 3.6%, infectious morbidity 2.0%, wound morbidity 1.4%, 30 day respiratory morbidity 2.0%, venous thromboembolic event morbidity 0.5%, postoperative blood transfusion 0.2%, and maternal mortality 0.25%.

CONCLUSION

Major maternal postoperative complications following nonobstetric antenatal surgery were low (5.8%). Maternal postoperative mortality was rare (0.25%).

摘要

目的

我们的主要目的是评估非产科产前手术后产妇术后30天内主要并发症的发生率。

方法

我们分析了美国外科医师学会国家外科质量改进计划2005 - 2009年的数据文件,以评估孕期任何阶段接受非产科产前手术的孕妇的手术结果,这些手术按照CPT - 4编码分类。采用t检验、χ²检验、逻辑回归分析及其他检验方法来计算术后30天内的综合主要并发症以及术前预测因素与术后30天发病率之间的关联。

结果

在纳入研究的1969名女性中,最常见的非产科产前手术是阑尾切除术(44.0%)。术后30天综合主要并发症的发生率为5.8%(n = 115)。这包括(并非相互排斥的类别):术后30天内返回手术室3.6%、感染性并发症2.0%、伤口并发症1.4% , 术后30天呼吸系统并发症2.0%、静脉血栓栓塞事件并发症0.5%、术后输血0.2%以及孕产妇死亡率0.25%。

结论

非产科产前手术后产妇主要术后并发症发生率较低(5.8%)。产妇术后死亡率罕见(0.25%)。

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