再次剖宫产在降低医疗机构剖宫产率中的相关性。
The Relevance of the Second Cesarean Delivery in the Reduction of Institutional Cesarean Delivery Rates.
机构信息
Department of Obstetrics and Gynecology, Faculty of Medicine, Kuwait University, Safat,
Department of Obstetrics and Gynecology, Maternity Hospital, Safat,
出版信息
Med Princ Pract. 2018;27(6):555-561. doi: 10.1159/000493362. Epub 2018 Aug 30.
OBJECTIVE
The cesarean delivery rate has increased worldwide. The aim of our study was to assess the events associated with the second cesarean deliveries in our institution.
SUBJECTS AND METHODS
All cesarean deliveries at the Maternity Hospital, Kuwait, from January 1 to December 31, 2013, were identified. A comparative study was undertaken on patients having their first and second cesarean deliveries. The social and clinical characteristics of these patients were extracted from our records and the antenatal, intrapartum, and postpartum course of the pregnancies and their outcomes documented.
RESULTS
During the study period, 10,586 deliveries were recorded, including 3,676 cesarean deliveries, i.e., a cesarean delivery rate of 34.7%. 840 of these patients were undergoing their first cesarean delivery (group A) and 607 patients were undergoing their second (group B); 484 patients from group A and 341 patients from group B with complete records were analyzed. Mean age (30.89 ± 4.93 vs. 29.94 ± 5.56 years, p = 0.008), parity (1.49 ± 1.22 vs. 0.98 ± 1.60, p < 0.0001), gestational age at delivery (38.12 ± 2.61 vs. 37.66 ± 3.11 weeks, p = 0.02), and fetal birth weight (3,211.60 ± 691.51 vs. 2,829.73 ± 863.26 g, p < 0.001) were significantly higher in group B than in group A. 53.2% of the patients in group B requested repeat cesarean delivery, their second cesarean. The rate of maternal morbidity was low.
CONCLUSIONS
The incidence of repeat cesarean delivery in group B is high, and its reduction should contribute to a lowering of the overall cesarean delivery rate.
目的
全球剖宫产率不断上升。本研究旨在评估我院再次剖宫产相关事件。
方法
我们对科威特妇产医院 2013 年 1 月 1 日至 12 月 31 日期间所有剖宫产分娩病例进行了分析。对行首次和再次剖宫产的患者进行了对比研究。我们从病历中提取了这些患者的社会和临床特征，并记录了其妊娠的产前、产时和产后过程及其结局。
结果
研究期间共记录了 10586 例分娩，其中 3676 例为剖宫产，剖宫产率为 34.7%。840 例患者行首次剖宫产（A 组），607 例患者行再次剖宫产（B 组）；对 A 组 484 例和 B 组 341 例有完整记录的患者进行了分析。B 组患者的平均年龄（30.89 ± 4.93 岁比 29.94 ± 5.56 岁，p = 0.008）、产次（1.49 ± 1.22 比 0.98 ± 1.60，p < 0.0001）、分娩时的孕周（38.12 ± 2.61 周比 37.66 ± 3.11 周，p = 0.02）和胎儿出生体重（3211.60 ± 691.51 克比 2829.73 ± 863.26 克，p < 0.001）均显著高于 A 组。B 组中有 53.2%的患者要求再次行剖宫产，即再次接受了剖宫产术。产妇发病率较低。
结论
B 组再次剖宫产率较高，降低这一比例应有助于降低总体剖宫产率。
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