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产前静脉滴注缩宫素对择期剖宫产新生儿呼吸系统疾病的影响。

Impact of antenatal oxytocin infusion on neonatal respiratory morbidity associated with elective cesarean section.

作者信息

Abdelazim Ibrahim, Farghali Mohamed M M, Elbiaa Assem A M, Abdelrazak Khaled M, Hussain Mohamed, Yehia Amr H, Rashad Mona

机构信息

Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt.

Department of Obstetrics and Gynecology, Ahmadi Hospital, Kuwait.

出版信息

Arch Med Sci. 2017 Apr 1;13(3):629-634. doi: 10.5114/aoms.2017.67292. Epub 2017 Apr 20.

Abstract

INTRODUCTION

This study was designed to estimate respiratory morbidity associated with elective cesarean section (ECS) and to determine the effect of antenatal oxytocin exposure on this morbidity.

MATERIAL AND METHODS

Nine hundred and sixty-five neonates ≥ 37 weeks' gestation delivered by cesarean section during 1 year were included in this retrospective study and classified into two groups according to oxytocin exposure before cesarean deliveries. Respiratory morbidity for each group was recorded and statistically analyzed.

RESULTS

Transient tachypnea of newborn (TTN) was significantly more frequent in group II (ECS group) than in group I (cesarean section after oxytocin exposure) (8.19% vs. 2.92%; respectively, = 0.0006). Mechanical ventilation, continuous positive airway pressure (CPAP) and oxygen therapy were significantly more frequent in group II than in group I (1.78%, 2.14% and 4.28% versus 0.44%, 0.58% and 1.46%, respectively; = 0.039, and = 0.033 and = 0.009, respectively). The number of newborns admitted to the neonatal unit and neonatal intensive care unit (NICU) was significantly higher in group II than in group I (6.41% and 2.14% vs. 2.05% and 0.58%, respectively; = 0.001 and = 0.033, respectively). Surfactant, fluid therapies and parenteral nutrition were significantly more frequent in group II than in group I (2.14%, 4.28% and 2.49% vs. 0.15%, 1.46% and 0.73%, respectively; = 0.001, = 0.009 and = 0.02, respectively).

CONCLUSIONS

Neonatal respiratory morbidity associated with ECS significantly decreased after antenatal oxytocin exposure. A significant reduction of neonatal respiratory morbidity would be achieved if ECS were performed after 39 weeks' gestation.

摘要

引言

本研究旨在评估择期剖宫产(ECS)相关的呼吸系统发病率,并确定产前使用缩宫素对该发病率的影响。

材料与方法

本回顾性研究纳入了1年内剖宫产分娩的965例孕周≥37周的新生儿,并根据剖宫产术前缩宫素的使用情况将其分为两组。记录并统计分析每组的呼吸系统发病率。

结果

第二组(ECS组)新生儿短暂性呼吸急促(TTN)的发生率显著高于第一组(缩宫素暴露后剖宫产组)(分别为8.19%和2.92%;P = 0.0006)。第二组机械通气、持续气道正压通气(CPAP)和氧疗的发生率显著高于第一组(分别为1.78%、2.14%和4.28%,而第一组分别为0.44%、0.58%和1.46%;P = 0.039、P = 0.033和P = 0.009)。第二组入住新生儿病房和新生儿重症监护病房(NICU)的新生儿数量显著高于第一组(分别为6.41%和2.14%,而第一组分别为2.05%和0.58%;P = 0.001和P = 0.033)。第二组表面活性剂、液体疗法和肠外营养的使用频率显著高于第一组(分别为2.14%、4.28%和2.49%,而第一组分别为0.15%、1.46%和0.73%;P = 0.001、P = 0.009和P = 0.02)。

结论

产前使用缩宫素后,与ECS相关的新生儿呼吸系统发病率显著降低。如果在孕39周后进行ECS,新生儿呼吸系统发病率将显著降低。

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