Kok N, Ruiter L, Lindeboom R, de Groot C, Pajkrt E, Mol B W, Kazemier B M
Department of Obstetrics and Gynecology, VU University Medical Centre, Amsterdam, The Netherlands.
Department of Obstetrics and Gynecology, Academic Medical Centre, Amsterdam, The Netherlands.
Eur J Obstet Gynecol Reprod Biol. 2015 Dec;195:214-218. doi: 10.1016/j.ejogrb.2015.09.011. Epub 2015 Oct 17.
To determine neonatal and short term maternal outcomes according to intentional mode of delivery following a cesarean delivery (CD).
Women pregnant after CD between January 2000 and December 2007 were categorized according to whether they had an elective repeat CD (ERCD) or a Trial of Labor (TOL). Prognostically equal ERCD and TOL groups were created using the propensity score matching technique. Conditional logistic regression was performed to assess differences in neonatal and maternal outcomes.
Women in their second ongoing pregnancy with a history of CD.
After ERCD the rates of low 5min Apgar score (OR 0.3, 95%CI 0.2-0.5, p<0.001), meconium aspiration (OR 0.0, 95%CI 0-0.7, p=0.02) and birth trauma (OR 0.08, 95%CI 0.002-0.5, p<0.001) were lower compared to TOL. The rate of transient tachypnoea of the newborn (TTN) appears higher in the ERCD group (OR 1.7, 95%CI 1.0-2.8, p=0.04). Uterine rupture (OR 0.1, 95%CI 0.003-0.8, p=0.02) and hemorrhage (OR 0.6, 95%CI 0.5-0.8, p<0.001) occurred less in the ERCD group.
Neonatal and short term maternal morbidity appears to be lower after ERCD than after TOL. Only TTN was seen more often after ERCD.
根据剖宫产术后的分娩方式确定新生儿及产妇短期结局。
将2000年1月至2007年12月剖宫产术后再次妊娠的女性，根据她们是进行择期再次剖宫产（ERCD）还是尝试经阴道分娩（TOL）进行分类。采用倾向评分匹配技术创建预后相当的ERCD组和TOL组。进行条件逻辑回归以评估新生儿和产妇结局的差异。
有剖宫产史的第二次妊娠女性。
与TOL相比，ERCD后5分钟Apgar评分低（OR 0.3，95%CI 0.2 - 0.5，p<0.001）、胎粪吸入（OR 0.0，95%CI 0 - 0.7，p = 0.02）和产伤（OR 0.08，95%CI 0.002 - 0.5，p<0.001）的发生率较低。ERCD组新生儿短暂性呼吸急促（TTN）的发生率似乎更高（OR 1.7，95%CI 1.0 - 2.8，p = 0.04）。ERCD组子宫破裂（OR 0.1，95%CI 0.003 - 0.8，p = 0.02）和出血（OR 0.6，95%CI 0.5 - 0.8，p<0.001）的发生率较低。
ERCD后新生儿及产妇短期发病率似乎低于TOL。仅ERCD后TTN更常见。
