Le Thai N, Darbois Y, Lefebvre G, Soudre G, Vauthier-Brouzes D, Fitoussi A, Clough K
Hôpital Pitié-Salpêtrière, Paris.
J Gynecol Obstet Biol Reprod (Paris). 1993;22(2):197-201.
Having carried out four cases of vaginal caesarean section the authors describe the technique they used. The advantages of the operation are: it is simple and can be carried out quickly, future obstetric behaviour is not compromised. It is important to avoid two complications of the operation: haemorrhage and injury to the bladder. These are reduced if the vertical incision in the cervix is made in the midline and long enough. The ideal indications for the operation are absence of cervical dilatation, or the occurrence of severe maternal haemorrhage during the operation to terminate a pregnancy, or while the uterine contents are being expelled towards the end of the second trimester. It is disputable whether there is a place for vaginal caesarean operation when the fetus is alive, in view of the recent studies on fetal prognosis.
作者在实施了4例经阴道剖宫产术后,描述了他们所采用的技术。该手术的优点是:操作简单且能迅速完成,不会影响未来的产科处理。避免该手术的两种并发症很重要:出血和膀胱损伤。如果宫颈的纵切口在中线且足够长,这些并发症会减少。该手术的理想适应证是宫颈未扩张,或在终止妊娠手术期间出现严重母体出血,或在妊娠中期末胎儿娩出时出现严重母体出血。鉴于最近关于胎儿预后的研究,当胎儿存活时,经阴道剖宫产手术是否有存在的价值存在争议。