Proctor-Brown Lauren A, Cheong Soon Hon, Diel de Amorim Mariana
Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
Vet Med Sci. 2019 Aug;5(3):336-344. doi: 10.1002/vms3.163. Epub 2019 Mar 6.
In human medicine, there is a recommended decision to delivery interval (DDI), which allows for the optimization of protocols and systematic review of hospital success. In veterinary medicine, no such guideline has been established or investigated. The purpose of this study was to investigate the relationship between the interval from the decision to perform a caesarean section and the delivery of the neonates and fetal mortality at the time of surgery. One hundred and fifty canine caesarean sections were evaluated retrospectively. Caesarean cases were dichotomized to those that had at least one perinatal death and cases where all puppies survived. Factors that increased the likelihood of at least one perinatal death at caesarean section were: cases that presented as an emergency caesarean section, the dam presenting with a fetus in the vaginal canal, the dam not having a history of previous caesareans sections, and being multiparous. Even though there was no association of DDI with likelihood of having perinatal death, timing related factors that increased the likelihood of having at least one perinatal death at caesarean section were: cases where total anaesthesia time was longer than 2 h; time from induction to start of surgery was longer than 45 min and surgical time longer than 75 min. In conclusion, time is a factor in the success of canine caesarean sections and further research is needed to better define the optimal decision to delivery time in canine caesarean sections in order to optimize fetal survival and hospital protocol success rates.
在人类医学中,存在推荐的决定至分娩间隔时间(DDI),这有助于优化方案并对医院的成功率进行系统评价。在兽医学中,尚未建立或研究此类指南。本研究的目的是调查决定进行剖宫产至新生儿分娩的间隔时间与手术时胎儿死亡率之间的关系。对150例犬剖宫产病例进行了回顾性评估。剖宫产病例被分为至少有1例围产期死亡的病例和所有幼犬均存活的病例。剖宫产时增加至少1例围产期死亡可能性的因素有:急诊剖宫产病例、母犬阴道内有胎儿、母犬无既往剖宫产史以及为经产母犬。尽管DDI与围产期死亡可能性无关联,但剖宫产时增加至少1例围产期死亡可能性的时间相关因素有:全身麻醉总时间超过2小时;诱导至开始手术的时间超过45分钟且手术时间超过75分钟。总之,时间是犬剖宫产成功的一个因素,需要进一步研究以更好地确定犬剖宫产的最佳决定至分娩时间,从而优化胎儿存活率和医院方案成功率。