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法国门诊剖宫产术:安全性和恢复特点。

The French Ambulatory Cesarean Section: Safety and Recovery Characteristics.

机构信息

Department of Obstetrics and Gynecology, Nazareth Hospital EMMS, Nazareth, Israel; Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.

Department of Obstetrics and Gynecology, Nazareth Hospital EMMS, Nazareth, Israel; Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.

出版信息

J Obstet Gynaecol Can. 2024 Aug;46(8):102606. doi: 10.1016/j.jogc.2024.102606. Epub 2024 Jul 1.

Abstract

OBJECTIVES

The French AmbUlatory Extraperitoneal Cesarean Section (FAUCS) is aimed at improving patients' birth experience and recovery. However, data are scarce regarding its maternal and neonatal safety. This study seeks to compare maternal and neonatal outcomes between FAUCS and conventional cesarean deliveries at term.

METHODS

This was a retrospective cohort study involving women who underwent scheduled cesarean deliveries at term. We compared a total of 810 cases using the FAUCS technique with 217 cases using conventional cesarean deliveries. Surgical complications, adverse neonatal events, and maternal recovery parameters were compared.

RESULTS

The incidence of overall surgical complications was comparable between the 2 groups, with rates of 1.97% for FAUCS and 1.85% for the conventional cesarean deliveries. The rates of specific complications such as bladder injury (0.1%), bowel injury (0.1%), blood transfusion (1.35%), and postpartum hemorrhage (1%) were consistent with existing literature. Neonatal outcomes, including neonatal acidemia and admission rates to the neonatal intensive care unit, were comparable between the groups and demonstrated favourable comparisons with previously reported data. Notably, women in the FAUCS group required less analgesia, with only 0.8% receiving morphine, as opposed to 38% in the control group. Furthermore, the FAUCS group demonstrated significantly quicker recovery, with 86% achieving autonomy and early discharge at their discretion within 48 hours after operation, in contrast to only 17% in the control group.

CONCLUSIONS

When performed by experienced practitioners, FAUCS proves to be a safe procedure, with no increased risk for maternal or neonatal complications. Its significant benefits in terms of enhancing maternal recovery are noteworthy.

摘要

目的

法国经腹外剖宫产术(FAUCS)旨在改善产妇的分娩体验和恢复情况。然而,关于其母婴安全性的数据仍然有限。本研究旨在比较 FAUCS 与足月常规剖宫产术的母婴结局。

方法

这是一项回顾性队列研究,涉及接受足月计划性剖宫产术的妇女。我们比较了总共 810 例使用 FAUCS 技术的病例和 217 例使用常规剖宫产术的病例。比较了手术并发症、不良新生儿事件和产妇恢复参数。

结果

两组总体手术并发症发生率相当,FAUCS 组为 1.97%,常规剖宫产组为 1.85%。膀胱损伤(0.1%)、肠损伤(0.1%)、输血(1.35%)和产后出血(1%)等特定并发症的发生率与现有文献一致。新生儿结局,包括新生儿酸中毒和新生儿重症监护病房入院率,两组之间相当,并与先前报道的数据进行了有利比较。值得注意的是,FAUCS 组的女性需要较少的镇痛药物,只有 0.8%接受吗啡,而对照组为 38%。此外,FAUCS 组恢复更快,86%的患者在术后 48 小时内能够自主并提前出院,而对照组只有 17%。

结论

当由经验丰富的医生实施时,FAUCS 是一种安全的手术,不会增加母婴并发症的风险。其在促进产妇恢复方面的显著优势值得关注。

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