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一级与非一级原发性急诊剖宫产新生儿结局的比较:三级医院的一项回顾性记录审查

Comparison of neonatal outcomes between category-1 and non-category-1 Primary Emergency Cesarean Section: A retrospective record review in a tertiary care hospital.

作者信息

Ahmed Iffat, Amerjee Azra, Hoodbhoy Zahra

机构信息

Dr. Dur-e-Shahwar, FCPS. Department of Obstetrics and Gynaecology, The Aga Khan University Hospital, Karachi, Pakistan.

Dr. Iffat Ahmed, FCPS. Department of Obstetrics and Gynaecology, The Aga Khan University Hospital, Karachi, Pakistan.

出版信息

Pak J Med Sci. 2018 Jul-Aug;34(4):823-827. doi: 10.12669/pjms.344.14496.

DOI:10.12669/pjms.344.14496
PMID:30190735
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6115571/
Abstract

OBJECTIVE

To compare neonatal outcomes between Category-1 and Non-Category-1 Primary Emergency Cesarean Section.

METHODS

This was a retrospective analysis, conducted at Aga Khan University Hospital Karachi from January 1 2016 till December 31 2016. Non-probability purposive sampling technique was used. A sample size of 375 patients who had primary Emergency Caesarean Section (Em-CS) was identified by keeping CS rate of 41.5% and 5% bond on error. Data was collected from labor ward, operating theatre and neonatal ward records by using structured questionnaire.

RESULTS

In the current study, out of 375 participants who underwent primary Em-CS; majority (89.3%) were booked cases. Two-hundred-eighty-two (75.2%) were primiparous women. Two hundred and thirty (61.3%) were at term and 145(38.7%) were preterm. The main indication among Category-1 CS was fetal distress (15.7%). For Non-Category-1 CS, non-progress of labour (45.1%) was the leading cause of abdominal delivery. Except for APGAR score at one minute (p value = 0.048), no other variables were statistically significant when neonatal outcomes were compared among Category-1 and Non-Category-1 CS.

CONCLUSION

In this study, fetal distress and non-progress of labor were the main indications for Category-1 and Non-Category-1 CS respectively. We did not find statistically significant association between indications of Em CS and neonatal outcomes. However further prospective studies are required to confirm this association.

摘要

目的

比较1类和非1类原发性急诊剖宫产的新生儿结局。

方法

这是一项回顾性分析,于2016年1月1日至2016年12月31日在卡拉奇阿迦汗大学医院进行。采用非概率目的抽样技术。通过保持41.5%的剖宫产率和5%的误差范围,确定了375例进行原发性急诊剖宫产(Em-CS)的患者样本量。通过使用结构化问卷从产房、手术室和新生儿病房记录中收集数据。

结果

在本研究中,375名接受原发性Em-CS的参与者中;大多数(89.3%)是已预约病例。282名(75.2%)是初产妇。230名(61.3%)为足月产,145名(38.7%)为早产。1类剖宫产的主要指征是胎儿窘迫(15.7%)。对于非1类剖宫产,产程无进展(45.1%)是剖宫产的主要原因。在比较1类和非1类剖宫产的新生儿结局时,除了1分钟时的阿氏评分(p值=0.048)外,没有其他变量具有统计学意义。

结论

在本研究中,胎儿窘迫和产程无进展分别是1类和非1类剖宫产的主要指征。我们没有发现急诊剖宫产指征与新生儿结局之间存在统计学上的显著关联。然而,需要进一步的前瞻性研究来证实这种关联。

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Survey of Obstetric Care and Cesarean Delivery Rates in Shanghai, China.中国上海产科护理与剖宫产率调查
Birth. 2016 Sep;43(3):193-9. doi: 10.1111/birt.12231. Epub 2016 Mar 18.
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The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014.剖宫产率的上升趋势:全球、区域和国家估计:1990 - 2014年
PLoS One. 2016 Feb 5;11(2):e0148343. doi: 10.1371/journal.pone.0148343. eCollection 2016.
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BMJ Open. 2015 Jul 29;5(7):e007248. doi: 10.1136/bmjopen-2014-007248.
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Placental abruption and subsequent risk of pre-eclampsia: a population-based case-control study.胎盘早剥及子痫前期的后续风险:一项基于人群的病例对照研究。
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Acta Obstet Gynecol Scand. 2014 Jun;93(6):571-86; discussion 587-8. doi: 10.1111/aogs.12412.
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Trends in caesarean delivery by country and wealth quintile: cross-sectional surveys in southern Asia and sub-Saharan Africa.按国家和财富五分位数划分的剖宫产趋势:南亚和撒哈拉以南非洲的横断面调查
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Cesarean delivery rates vary tenfold among US hospitals; reducing variation may address quality and cost issues.美国各医院的剖宫产率差异高达十倍;降低这种差异可能有助于解决质量和成本问题。
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