Luu P, Mestdagh B, Barré-Drouard C, Richart P, Courtecuisse-Vamour C, Rakza T, Garabedian C, Subtil D
Hôpital Jeanne-de-Flandre, université de Lille, CHU de Lille, 59000 Lille, France.
Hôpital Jeanne-de-Flandre, université de Lille, CHU de Lille, 59000 Lille, France.
Gynecol Obstet Fertil Senol. 2019 Apr;47(4):342-346. doi: 10.1016/j.gofs.2019.01.005. Epub 2019 Jan 25.
Considering its benefits, immediate skin-to-skin should be applied irrespective of the way of delivery. While it is increasingly applied in case of vaginal delivery, it remains difficult to implement in case of caesarean section.
To estimate the degree of implementation of skin-to-skin in case of caesarean section.
Survey in immediate postpartum with a continuous series of patients having given birth by caesarean - whether scheduled or not - in a level 3 hospital systematically realizing skin-to-skin in case of vaginal delivery. The patients were included if the caesarean section had been realized between 16/11/17 and 28/11/17.
Thirty-five women gave birth by caesarean section during the period of study, among which 26 were planned (74%). The emergency levels were varied: 18 had a green code (51%), 12 an orange code (34%) and 5 a red code (14%). Forty-six percent of the newborn children were placed skin-to-skin. The frequency of skin-to-skin was closely linked to the planned character of the caesarean section (89 vs. 31%, P=0.005), as well as its color code (green 72%, orange 25%, red 0%). In case of impossibility to realize skin-to-skin in the course of the caesarean, the reasons were mainly related to the maternal state (63%) (malaise, bleeding, pain). In this situation, skin-to-skin was proposed to the spouse in 83% of cases and realized in recovery room with the mother in 82% of the cases.
Skin-to-skin is feasible during caesarean section, regardless of the color code of the procedure.
鉴于即时皮肤接触的益处,无论分娩方式如何,均应采用。虽然其在阴道分娩中应用越来越广泛,但在剖宫产中实施起来仍有困难。
评估剖宫产时皮肤接触的实施程度。
对一家三级医院中连续一系列剖宫产分娩的产妇(无论是否为择期剖宫产)进行产后即时调查,该医院在阴道分娩时系统地实施皮肤接触。若剖宫产在2017年11月16日至2017年11月28日期间进行,则纳入这些产妇。
在研究期间,35名妇女通过剖宫产分娩,其中26例为择期剖宫产(74%)。急诊程度各不相同:18例为绿色代码(51%),12例为橙色代码(34%),5例为红色代码(14%)。46%的新生儿进行了皮肤接触。皮肤接触的频率与剖宫产的计划性密切相关(89%对31%,P = 0.005),也与其颜色代码有关(绿色72%,橙色25%,红色0%)。若剖宫产过程中无法进行皮肤接触,主要原因与产妇状况有关(63%)(不适、出血、疼痛)。在这种情况下,83%的病例向配偶提议进行皮肤接触,82%的病例在恢复室与母亲一起进行了皮肤接触。
剖宫产时进行皮肤接触是可行的,无论手术的颜色代码如何。