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相对指征剖宫产与自然阴道分娩:母婴健康的短期结局

Cesarean section with relative indications versus spontaneous vaginal delivery: short-term outcomes of maternofetal health.

作者信息

Arikan I, Barut A, Harma M, Harma I M, Gezer S, Ulubasoglu H

机构信息

Department of Gynecology and Obstetrics, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak Children and Maternity Hospital, Zonguldak, Turkey.

出版信息

Clin Exp Obstet Gynecol. 2012;39(3):288-92.

Abstract

AIM

The aim of the study was to compare maternal and perinatal mortality and short-term outcomes of maternal and perinatal health between a cesarean group with relative indications and a vaginal delivery group.

METHODS

A total of 1,119 patients were included; 582 were delivered by spontaneous vaginal birth and 537 delivered by cesarean section without labor. The indication for cesarean section was tocophobia and fear of childbirth for all patients. Maternal and perinatal morbidity and mortality were compared between the groups.

RESULTS

No maternal mortality was recorded. Maternal morbidity was significantly lower in the vaginal birth group than the cesarean group (7 vs 30, p<0.05). Perinatal mortality (2 vs 0) and perinatal morbidity were not significantly different between the two groups (33 vs 17). The vaginallly delivered group had significantly higher newborn hospitalization rates than the cesarean group (p<0.05), but hospitalization time did not differ. Newborns with the first minute Apgar score below 7 were higher in the cesarean group (p<0.05). Fifth minute Apgar scores and umblical cord pH values were similiar. Cesarean neonates weighed more than vaginally delivered ones (p<0.05).

CONCLUSION

Short-term maternal complications were more frequently seen in cesarean deliveries with relative indications than spontanous vaginal deliveries but no difference was found in perinatal mortality and morbidity. There is a clear need for research on health outcomes for mothers and infants associated with cesarean delivery without any medical indication.

摘要

目的

本研究旨在比较有相对指征的剖宫产组与阴道分娩组的孕产妇及围产期死亡率,以及孕产妇和围产期健康的短期结局。

方法

共纳入1119例患者;582例经自然阴道分娩,537例未临产而行剖宫产。所有患者剖宫产的指征均为分娩恐怖症和害怕分娩。比较两组间孕产妇及围产期的发病率和死亡率。

结果

未记录到孕产妇死亡。阴道分娩组的孕产妇发病率显著低于剖宫产组(7例 vs 30例,p<0.05)。两组间围产期死亡率(2例 vs 0例)和围产期发病率无显著差异(33例 vs 17例)。阴道分娩组的新生儿住院率显著高于剖宫产组(p<0.05),但住院时间无差异。剖宫产组1分钟阿氏评分低于7分的新生儿更多(p<0.05)。5分钟阿氏评分和脐动脉血pH值相似。剖宫产新生儿体重高于阴道分娩新生儿(p<0.05)。

结论

有相对指征的剖宫产分娩的短期孕产妇并发症比自然阴道分娩更常见,但围产期死亡率和发病率无差异。对于无任何医学指征的剖宫产分娩对母婴健康结局的影响,显然需要开展研究。

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