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产妇在产程发动后行第三次剖宫产术的母婴结局。

Maternal Outcome in Pregnant Women Undergoing Third Caesarean Section After Onset of Labor.

机构信息

Department of Obstetrics and Gynecology, Florence-Nightingale-Hospital, Düsseldorf, Germany;

Department of Obstetrics and Gynecology, Florence-Nightingale-Hospital, Düsseldorf, Germany.

出版信息

In Vivo. 2024 Nov-Dec;38(6):2718-2728. doi: 10.21873/invivo.13750.

Abstract

BACKGROUND/AIM: Our study compares repeat cesarian section with and without labor in progress and evaluates adverse maternal outcomes that could discourage pregnant women in planning labor at term or at least after 39 weeks of gestation as recommended due to benefits in neonatal outcome.

PATIENTS AND METHODS

In this retrospective study, we analyzed 191 patients undergoing third C-section and compared two groups of women of undergoing C-section either before or after the onset of labor. The primary outcome measure was the incidence of maternal morbidity. Values of p≤0.05 were regarded as significant.

RESULTS

Comparing the two subgroups, we did not find any significant differences in the occurrence of maternal complications or severe acute morbidity except for incomplete uterine rupture (p=0.04).

CONCLUSION

Undergoing a third C-section after the start of labor has no relevant or adverse impact on maternal outcome. Therefore, elective repeat C-section can be planned in late weeks of gestation aiming at reducing neonatal morbidity. The higher rate of uterine dehiscence was not associated with other issues of severe acute maternal morbidity.

摘要

背景/目的:我们的研究比较了有进展的和无进展的重复剖宫产,并评估了可能会因新生儿结局获益而劝阻孕妇在足月或至少在 39 孕周后计划分娩的不良母婴结局。

患者和方法

在这项回顾性研究中,我们分析了 191 名接受第三次剖宫产的患者,并比较了两组在产程开始前或开始后行剖宫产的女性。主要结局指标是产妇发病率。p 值≤0.05 被认为具有统计学意义。

结果

比较两个亚组,我们没有发现产妇并发症或严重急性并发症的发生率有任何显著差异,除了不完全性子宫破裂(p=0.04)。

结论

在产程开始后行第三次剖宫产对母婴结局没有相关或不利的影响。因此,为了降低新生儿发病率,可以在妊娠晚期计划选择性重复剖宫产。更高的子宫切开率与其他严重急性产妇发病率问题无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a6c/11535941/325629210f0a/in_vivo-38-2719-g0001.jpg

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