Schreiner R L, Stevens D C, Smith W L, Lemons J A, Golichowski A M, Padilla L M
Am J Obstet Gynecol. 1982 Jul 15;143(6):689-92. doi: 10.1016/0002-9378(82)90116-8.
The clinical course and chest radiographs of 47 infants with respiratory distress after elective cesarean section were reviewed. The mean difference between the gestational age determined prenatally and that postnatally was 2.6 +/- 1.6 weeks. However, 14 of the infants were delivered at term. All 47 infants required more than 40% oxygen, and 18 infants required a respirator. Fifteen infants developed a pneumothorax; one, a pneumopericardium; one, bronchopulmonary dysplasia; and one infant died. Chest radiographs and the clinical course were consistent with hyaline membrane disease in 17 patients; respiratory distress syndrome type II in 24; and in three the radiographic findings were normal. These data suggest that some of the respiratory morbidity subsequent to elective repeat cesarean section is not secondary to iatrogenic delivery of a premature infant, and that much of it is not due to hyaline membrane disease. These data emphasize that respiratory distress in an infant delivered by elective cesarean section does not necessarily suggest poor prenatal care in regard to the timing of delivery.
回顾了47例择期剖宫产术后出现呼吸窘迫的婴儿的临床病程及胸部X光片。产前确定的孕周与产后确定的孕周的平均差值为2.6±1.6周。然而，其中14例婴儿为足月分娩。所有47例婴儿均需要40%以上的氧气，18例婴儿需要使用呼吸机。15例婴儿发生气胸；1例发生心包积气；1例发生支气管肺发育不良；1例婴儿死亡。胸部X光片及临床病程显示，17例患者符合透明膜病；24例符合II型呼吸窘迫综合征；3例X光片检查结果正常。这些数据表明，择期再次剖宫产术后的一些呼吸系统疾病并非继发于医源性早产，且其中大部分并非由透明膜病所致。这些数据强调，择期剖宫产分娩的婴儿出现呼吸窘迫并不一定意味着在分娩时机方面产前护理不佳。
