Shan Dan, Han Jinbiao, Li Tao, Hu Yayi
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, No. 20, South Renmin Road, Section 3, Chengdu, 610041, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, 610041, China.
Arch Gynecol Obstet. 2024 Aug;310(2):915-921. doi: 10.1007/s00404-024-07472-8. Epub 2024 Apr 4.
The "en caul" cesarean section (CS) is a method to keep the amnion intact during CS. This amnion protection effect may have benefits in preterm twin pregnancy. This study aimed to explore the benefits and risks of this method in preterm twin pregnancy.
This study is a retrospective analysis of preterm twin pregnancies underwent CS in West China Second University Hospital of Sichuan University from January 2011 to December 2022. Data on maternal and fetal outcomes were collected. Univariable analyses and multivariate logistic regression analyses were applied. The level of significance was set at p < 0.05.
A total of 182 patients were included (90 in the "en caul" group, 92 in the conventional group). "en caul" CS was associated with lower incidence for respiratory distress (aOR 0.47, 95% CI 0.25-0.88, for the first fetus; aOR 0.42, 95% CI 0.21-0.82, for the second fetus). This method was proved to have beneficial effects in improving the Apgar scores at 1st minute and reducing the mechanical ventilation rate in the second neonates (aOR 0.41, 95% CI 0.19-0.88).
"En caul" CS is an easy and safe technique to perform during CS for preterm twin pregnancy. The efficacy and safety of this method could be tested by future studies with larger sample size.
“胎膜完整”剖宫产术是一种在剖宫产时保持羊膜完整的方法。这种羊膜保护作用可能对早产双胎妊娠有益。本研究旨在探讨该方法在早产双胎妊娠中的益处和风险。
本研究是对2011年1月至2022年12月在四川大学华西第二医院接受剖宫产的早产双胎妊娠进行的回顾性分析。收集母婴结局数据。应用单因素分析和多因素逻辑回归分析。显著性水平设定为p < 0.05。
共纳入182例患者（“胎膜完整”组90例，传统组92例）。“胎膜完整”剖宫产与呼吸窘迫发生率较低相关（第一胎儿：调整后比值比0.47，95%置信区间0.25 - 0.88；第二胎儿：调整后比值比0.42，95%置信区间0.21 - 0.82）。该方法被证明在提高第一分钟阿氏评分和降低第二个新生儿机械通气率方面有有益作用（调整后比值比0.41，95%置信区间0.19 - 0.88）。
“胎膜完整”剖宫产术是早产双胎妊娠剖宫产时一种简单安全的技术。该方法的有效性和安全性可通过未来更大样本量的研究进行验证。
