Gurung Padma, Malla Sameer, Lama Sushma, Malla Anagha, Singh Alka
Department of Obstetrics and Gynecology, Patan Hospital, GPO 24900, Lalitpur,Nepal.
Department of Obstetrics and Gynecology, Patan Hospital, GPO 24900, Lalitpur, Nepal.
J Nepal Health Res Counc. 2017 Sep 8;15(2):178-181. doi: 10.3126/jnhrc.v15i2.18210.
There is an alarming rise in caesarean section leading to increased adverse outcomes for both the mother and fetus when compared with vaginal delivery. Within this increasing caesarean section rate, there is a concerning increase in the rate of second stage caesarean section. This study highlight the feto-maternal outcome of caesarean section in second stage of labour.
This was a retrospective cohort review of all women with a singleton, cephalic fetus at term delivered by caesarean section in the second stage of labor between April 1, 2013 and March 30, 2017 at Patan Academy of Health Sciences. The main outcome measures were second stage caesarean section, indications and its maternal and fetal morbidity.
During the study period, there were 40,860 deliveries. A total of 18,011 (44%) babies were born by caesarean section, 10484 emergency and 7527 elective. Out of the emergency caesarean section, 200 (1.9 %) were performed in second stage of labor. In this study, the most common indication was cephalopelvic disproportion. (92.4%) were delivered without a trial of instrumental delivery. In terms of maternal complications, atonic post partum haemorrhage uterine incision extension 18 (12.5%), postoperative fever 27(18.8%), wound infection 7 (4.8%) were observed. In perinatal complications, meconium stained amniotic fluid 49(34.2%), neonatal hyperbilirubinemia 14(9.7%) and increased nursery admission 2(15.3%) and 2(1.3%) perinatal mortality were seen.
Cesarean sections done in second stage of labor are associated with several intra-operative maternal complications and neonatal morbidity.
剖宫产率惊人地上升，与阴道分娩相比，这导致母亲和胎儿的不良后果增加。在不断上升的剖宫产率中，第二产程剖宫产率的增加令人担忧。本研究强调了第二产程剖宫产的母婴结局。
这是一项对2013年4月1日至2017年3月30日在帕坦健康科学学院进行第二产程剖宫产分娩的所有单胎足月头位胎儿妇女的回顾性队列研究。主要结局指标为第二产程剖宫产、指征及其母婴发病率。
在研究期间，共有40860例分娩。共有18011例（44%）婴儿通过剖宫产出生，其中10484例为急诊剖宫产，7527例为择期剖宫产。在急诊剖宫产中，200例（1.9%）在第二产程进行。在本研究中，最常见的指征是头盆不称。92.4%的产妇未尝试器械助产就进行了分娩。在母亲并发症方面，观察到产后宫缩乏力性出血、子宫切口延长18例（12.5%）、术后发热27例（18.8%）、伤口感染7例（4.8%）。在围产期并发症方面，观察到羊水粪染49例（34.2%）、新生儿高胆红素血症14例（9.7%）、新生儿入住新生儿重症监护病房增加2例（15.3%）以及围产儿死亡率2例（1.3%）。
第二产程剖宫产与多种术中母亲并发症和新生儿发病率相关。
