Blagaić Vladimir, Stanojević Milan, Jelčić Ana
Department of Obstetrics and Gynecology, Medical School University of Zagreb , Clinical Hospital "Sv. Duh", Zagreb , Croatia.
J Matern Fetal Neonatal Med. 2014 Mar;27(4):393-6. doi: 10.3109/14767058.2013.818119. Epub 2013 Dec 2.
More than 50 percent of preterm neonates below 28 gestational weeks in our institution are delivered by cesarean section (CS).
To present advantages of less used method of delivery of premature and/or very low birth weight (VLBW) neonates by Amnion Protective Cesarean Section (APCS) when indicated and to review our experience with the method. It can be used in all deliveries by CS with unruptured amniotic membranes, at all gestational ages.
Including criteria were singleton pregnancies, gestation of 26 to 35 weeks and birth body weight between 700 to 1500 g. According to the criteria, during the studied period 10 neonates were delivered by APCS. We compared the outcomes of APCS neonates with ones delivered by coventional CS who matched them in mentioned criteria.
Compared to CS cases, APCS neonates had statistically significant better first minute AS. Stay in NICU was shorter for APCS neonates but not statistically significant. From our experience APCS neonates had clinically better appearance (less bruises and hematomas).
APCS is promising method for delivery of preterm and/or VLBW neonates when indicated, although prospective studies are needed in order to prove its effectiveness compared to conventional CS.
在我们机构中，孕周小于28周的早产新生儿超过50%是通过剖宫产分娩的。
介绍在有指征时采用羊膜保护剖宫产（APCS）这种较少使用的方法来分娩早产和/或极低出生体重（VLBW）新生儿的优势，并回顾我们使用该方法的经验。它可用于所有孕周、胎膜未破的剖宫产分娩。
纳入标准为单胎妊娠、孕周26至35周且出生体重700至1500克。根据该标准，在研究期间有10例新生儿通过APCS分娩。我们将APCS分娩的新生儿与在上述标准方面匹配的传统剖宫产分娩的新生儿的结局进行了比较。
与剖宫产病例相比，APCS分娩的新生儿在出生后第一分钟的阿氏评分在统计学上有显著更好的表现。APCS分娩的新生儿在新生儿重症监护病房（NICU）的住院时间较短，但无统计学意义。根据我们的经验，APCS分娩的新生儿外观在临床上更好（瘀伤和血肿较少）。
APCS是一种在有指征时用于分娩早产和/或VLBW新生儿的有前景的方法，尽管需要进行前瞻性研究以证明其与传统剖宫产相比的有效性。
