低风险未产妇的急诊剖宫产
Emergency caesarean section in low risk nulliparous women.
作者信息
Haerskjold A, Hegaard H K, Kjaergaard H
机构信息
AH Research assistant, Pediatric Department, The Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital Rigshospitalet, DK 2100 Københavnø, Denmark. annhaerskjoldmail.com
出版信息
J Obstet Gynaecol. 2012 Aug;32(6):543-7. doi: 10.3109/01443615.2012.689027.
The rising incidence of caesarean section (CS), including emergency caesarean section (ECS) in nulliparas is of concern. Previous CS may have implications for future pregnancies and deliveries. This article describes the prevalence and indications for ECS in a cohort of low risk nulliparas and identifies maternal and fetal risk factors associated with ECS. We included 2,748 low-risk women and 8.7% had ECS. Failure-to-progress (FTP) accounted for 68.3% of the ECS and 30.4% were performed due to suspected fetal distress (SFD). Multivariate logistic regression analyses were done to estimate the association between risk factors and indications for ECS. Smoking during pregnancy (OR 2.33; CI 1.18-4.61) and BMI ≥ 30 (OR 2.87, CI 1.34-6.16) were associated with increased risk of ECS due to SFD. Birth weight (BW) ≥ 4,000 (OR 2.95; CI 1.92-4.53) and smoking cessation during pregnancy (OR 2.02; CI 1.26-3.20) were associated with increased risk of ECS due to FTP.
剖宫产（CS）发生率的上升，包括初产妇的急诊剖宫产（ECS），令人担忧。既往剖宫产可能会对未来的妊娠和分娩产生影响。本文描述了一组低风险初产妇中急诊剖宫产的患病率和指征，并确定了与急诊剖宫产相关的母体和胎儿风险因素。我们纳入了2748名低风险女性，其中8.7%进行了急诊剖宫产。产程停滞（FTP）占急诊剖宫产的68.3%，30.4%是由于可疑胎儿窘迫（SFD）而进行的。进行多因素逻辑回归分析以估计风险因素与急诊剖宫产指征之间的关联。孕期吸烟（OR 2.33；CI 1.18 - 4.61）和BMI≥30（OR 2.87，CI 1.34 - 6.16）与因可疑胎儿窘迫导致的急诊剖宫产风险增加相关。出生体重（BW）≥4000（OR 2.95；CI 1.92 - 4.53）和孕期戒烟（OR 2.02；CI 1.26 - 3.20）与因产程停滞导致的急诊剖宫产风险增加相关。
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