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剖宫产术后分娩管理中的特殊产科问题

[Special obstetric problems in managing labor following cesarean section].

作者信息

Wessel J, Ralph G, Lichtenegger W, Schorer P

机构信息

Universitätsfrauenklinik Charlottenburg der Freien Universität Berlin.

出版信息

Z Geburtshilfe Perinatol. 1989 May-Jun;193(3):134-8.

PMID:2763607
Abstract

The prevalence of primary repeat cesareans in the 37th and 38th weeks of gestation and the highest rate of premature births explain the shorter duration of pregnancy associated with this mode of delivery. In cases where ecbolics were administered labour was prolonged and the rate of secondary repeat cesareans was higher. Late rupture of the amniotic sac seems to increase the chances of successful vaginal delivery. Biparietal cranial diameter had no influence on the mode of delivery; significantly higher values were found only in cases of cranial-pelvic incongruity. The frequency of primary repeat cesareans increased in proportion to the age of the mother. The time interval since the previous cesarean delivery is of no importance. Birth weights were lower in the group of elective repeat cesareans owing to lower gestational age. It does not always appear justified to rule out a vaginal birth in cases of twins. Regional anesthesia is not a contraindication.

摘要

孕37周和38周时初次重复剖宫产的发生率以及早产的最高发生率解释了与这种分娩方式相关的较短孕期。在使用催产剂的情况下,产程延长,二次重复剖宫产的发生率更高。羊膜囊晚破似乎会增加阴道分娩成功的几率。双顶径对分娩方式没有影响;仅在头盆不称的情况下才会发现明显更高的值。初次重复剖宫产的频率与母亲年龄成正比。自上次剖宫产以来的时间间隔并不重要。由于孕周较小,择期重复剖宫产组的出生体重较低。在双胞胎情况下排除阴道分娩并不总是合理的。区域麻醉不是禁忌证。

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