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夏里特剖宫产:一种以家庭为导向的剖宫产方法。

The Charité cesarean birth: a family orientated approach of cesarean section.

作者信息

Armbrust Robert, Hinkson Larry, von Weizsäcker Katharina, Henrich Wolfgang

机构信息

a Department of Obstetrics , Charité University Hospital , Berlin , Germany.

出版信息

J Matern Fetal Neonatal Med. 2016;29(1):163-8. doi: 10.3109/14767058.2014.991917. Epub 2015 Jan 9.

Abstract

OBJECTIVE

To evaluate the safety and patients delivery experience of the Charité Cesarean Birth (CCB), a modified cesarean section (CS). Parents are actively integrated in the delivery process by direct visualization of the birth, cutting the umbilical cord and early skin-to-skin contact (STS).

METHODS

Women with an indication for a planned primary CS at term were included. Trial was conducted at the Charité University Hospital Berlin as a prospectively randomized controlled trial. Parameters of perinatal outcome for both mother and infant were assessed using modified Likert-Scales and a standardized questionnaire. Primary outcome measures were birth experience and satisfaction for parents. Parameters of breast feeding and consecutive problems. APGAR Scores, blood loss, perioperative complications were secondary outcome measures.

RESULTS

Birth experiences were rated significantly higher in the CCB group compared to a classical caesarean section (p < 0.05). There were no significant differences between APGAR Scores, need for admission to an intensive care unit. Also perioperative blood loss and cardiovascular disorders did not differ between the two groups. Early STS was achieved in the 72% of the cases with higher rates of breast-feeding in the CCB group.

CONCLUSIONS

The CCB leads to a significantly better birth experience. The procedure seems to be safe for both mother and infant. Patients become an active part of the CS by direct visualization of the birth and cutting the umbilical cord. The presented modification is a useful and safe option when a CS is medically indicated and necessary. It improves the breast-feeding and the early mother-infant interaction.

摘要

目的

评估改良剖宫产术——夏里特剖宫产术(CCB)的安全性及产妇分娩体验。通过直接观察分娩过程、剪断脐带和早期皮肤接触(STS),让产妇积极参与到分娩过程中。

方法

纳入足月计划行首次剖宫产术的产妇。该试验在柏林夏里特大学医院进行,为前瞻性随机对照试验。采用改良的李克特量表和标准化问卷评估母婴围产期结局参数。主要结局指标为产妇的分娩体验和满意度、母乳喂养及后续问题的参数。Apgar评分、失血量、围手术期并发症为次要结局指标。

结果

与传统剖宫产相比,CCB组的分娩体验评分显著更高(p < 0.05)。两组的Apgar评分、入住重症监护病房的需求无显著差异。两组的围手术期失血量和心血管疾病也无差异。72%的病例实现了早期皮肤接触,CCB组的母乳喂养率更高。

结论

CCB带来显著更好的分娩体验。该手术对母婴似乎都是安全的。通过直接观察分娩过程和剪断脐带,产妇成为剖宫产手术的积极参与者。当有医学指征且有必要进行剖宫产时,所提出的改良方法是一种有用且安全的选择。它改善了母乳喂养和母婴早期互动。

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