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2017年沙特阿拉伯吉达阿卜杜勒阿齐兹国王医疗城剖宫产的常见并发症

Common Complications of Cesarean Section During the Year 2017 in King Abdulaziz Medical City, Jeddah, Saudi Arabia.

作者信息

Aljohani Aljoharah A, Al-Jifree Hatim M, Jamjoom Refal H, Albalawi Rawan S, Alosaimi Amal M

机构信息

Medicine, King Abdullah International Medical Research Center, Jeddah, SAU.

Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU.

出版信息

Cureus. 2021 Jan 21;13(1):e12840. doi: 10.7759/cureus.12840.

Abstract

Cesarean section (CS) is one of the most well-known major obstetrics surgeries and one of the oldest operations in the area of abdominal surgery. It is used for the purpose of delivering the newborn and the placenta through the abdominal wall incision (laparotomy) as well as Uterine incision (hysterotomy), followed by suture of the uterus and abdominal wall layers. Most common maternal complications internationally, according to literature were bleeding and wound infection. Most common fetal complications according to the literature were depressed Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score, low blood pH and ICU admissions. The aim of this study is to determine the most common CS complications among all the deliveries at King Abdulaziz Medical City (KAMC) in Jeddah in 2017 and to estimate maternal and fetal complication rates following CS. Comparing the rate of complication between residents and non-residents physicians performing a CS was tested as a secondary outcome. To the best of our knowledge, this is a novel research in this medical center at KAMC Jeddah that will aid in quality improvement in both clinical services and training activities of residents. The maternal and fetal complication rates were assessed in a cross-sectional chart review study. In order for this method to be achieved, a secondary data collection sheet was constructed to collect all eligible patient health records. This literature review was based on estimating the rate of CS complications for the mothers and their neonates that founded approximately 7% and 6%, respectively, where the procedure was either performed electively or emergently within the period of 1 January to 31 December 2017. Also, all patients with medical and surgical conditions were included while intrauterine fetal death was excluded. The most common maternal complications documented in our population were bleeding and wound extension, while the most common fetal complications were low APGAR score and NICU admissions. No statistical significance was found in either complications in terms of the correlation between demographical factors, maternal health conditions and gravida status. As for the secondary objective, the association between operator level of training and rate of complications revealed a higher percentage rate of maternal and fetal complications among consultants, which were 6.2% and 8.2%, respectively, mainly because the number and complexity of their cases in comparison to cases held by residents and others.

摘要

剖宫产术(CS)是最广为人知的主要产科手术之一,也是腹部外科领域最古老的手术之一。它用于通过腹壁切口(剖腹术)以及子宫切口(子宫切开术)娩出新生儿和胎盘,随后缝合子宫和腹壁各层。根据文献,国际上最常见的产妇并发症是出血和伤口感染。根据文献,最常见的胎儿并发症是阿氏评分(外观、脉搏、 grimace 、活动和呼吸)低、血pH值低和入住重症监护病房。本研究的目的是确定2017年吉达阿卜杜勒阿齐兹国王医疗城(KAMC)所有分娩中最常见的剖宫产并发症,并估计剖宫产后的母婴并发症发生率。将实施剖宫产的住院医师和非住院医师之间的并发症发生率进行比较作为次要结果进行检验。据我们所知,这是吉达KAMC该医疗中心的一项新研究,将有助于提高临床服务和住院医师培训活动的质量。在一项横断面图表回顾研究中评估母婴并发症发生率。为了实现这种方法,构建了一份二级数据收集表以收集所有符合条件的患者健康记录。这篇文献综述基于对2017年1月1日至12月31日期间择期或急诊进行该手术的母亲及其新生儿的剖宫产并发症发生率的估计,分别约为7%和6%。此外,所有患有内科和外科疾病的患者均被纳入,而宫内胎儿死亡患者被排除。我们人群中记录的最常见的产妇并发症是出血和伤口扩大,而最常见的胎儿并发症是阿氏评分低和入住新生儿重症监护病房。在人口统计学因素、产妇健康状况和妊娠状态之间的相关性方面,两种并发症均未发现统计学意义。至于次要目标,手术者培训水平与并发症发生率之间的关联显示,顾问医生中母婴并发症的百分率较高,分别为6.2%和8.2%,主要是因为与住院医师和其他人员的病例相比,他们的病例数量和复杂性较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5369/7899252/9789d191f767/cureus-0013-00000012840-i01.jpg

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