Yaman Tunc Senem, Agacayak Elif, Sak Sibel, Basaranoglu Serdar, Goruk Neval Yaman, Turgut Abdulkadir, Tay Hayrettin, Elci Evindar, Gul Talip
a Department of Obstetrics and Gynecology , School of Medicine, Dicle University , Diyarbakir , Turkey.
b Department of Obstetrics and Gynecology , School of Medicine, Harran University , Sanliurfa , Turkey.
J Matern Fetal Neonatal Med. 2017 Mar;30(6):739-744. doi: 10.1080/14767058.2016.1183638. Epub 2016 May 20.
The aim of the present study is to evaluate the effects of the increased number of caesarean deliveries (CDs) in cases of multiple repeat caesarean deliveries (MRCDs) on maternal and neonatal morbidity.
MRCDs admitted to our hospital between January 2013 and September 2014 were analysed retrospectively. A total number of 1133 women were included in the study and were divided into 4 groups. Group 1: second CDs (n = 329); Group 2: third CDs (n = 225); Group 3: fourth CDs (n = 447); Group 4: fifth CDs (n = 132). The clinical, demographic, intraoperative and postoperative data of the patients were registered upon the review of patient files.
The differences among the groups were found to be statistically significant in terms of mean maternal age, gravida, APGAR (Activity, Pulse, Grimace, Appearance, Respiration) scores, hospital stay and operation time. In addition, the difference was also statistically significant for severe adhesion, bladder injury and premature birth. No statistically significant difference was observed among the groups with respect to placenta previa, placenta accreta, caesarean hysterectomy, uterine scar rupture.
According to our findings, MRCDs seem to increasing the maternal and neonatal morbidity even though they are not life-threatening.
本研究旨在评估多次重复剖宫产（MRCD）病例中剖宫产次数增加对孕产妇和新生儿发病率的影响。
回顾性分析2013年1月至2014年9月期间我院收治的MRCD病例。本研究共纳入1133名女性，分为4组。第1组：第二次剖宫产（n = 329）；第2组：第三次剖宫产（n = 225）；第3组：第四次剖宫产（n = 447）；第4组：第五次剖宫产（n = 132）。通过查阅患者病历记录患者的临床、人口统计学、术中及术后数据。
各组之间在孕产妇平均年龄、孕周、阿氏评分（活动、脉搏、 grimace反射、外观、呼吸）、住院时间和手术时间方面存在统计学显著差异。此外，在严重粘连、膀胱损伤和早产方面差异也具有统计学意义。在前置胎盘、胎盘植入、剖宫产子宫切除术、子宫瘢痕破裂方面，各组之间未观察到统计学显著差异。
根据我们的研究结果，尽管多次重复剖宫产不会危及生命，但似乎会增加孕产妇和新生儿的发病率。
