Chapman S J, Owen J, Hauth J C
Department of Obstetrics and Gynecology, University of Alabama at Birmingham, USA.
Obstet Gynecol. 1997 Jan;89(1):16-8. doi: 10.1016/s0029-7844(97)84257-3.
To determine whether a low transverse cesarean closure method in one or two layers affects subsequent pregnancy outcome.
In a prospective trial reported previously, 906 women were assigned randomly to either one- or two-layer uterine closure. One hundred sixty-four women had a subsequent pregnancy and delivery (18 weeks' gestation or longer) at our institution. Maternal and neonatal outcomes were ascertained by medical chart review and compared between the one- and two-layer closure groups.
Of the 164 subsequent deliveries, 83 had previous closure in one layer, whereas 81 had involved a two-layer closure. The demographic characteristics of these two groups were similar. Nineteen women (12%) underwent elective repeat cesareans without labor, and the remaining 145 experienced labor. Length of labor, mode of delivery, duration of hospital stay, gestation at delivery, and the incidences of uterine scar dehiscence, chorioamnionitis, postpartum metritis, hemorrhage, transfusion, and abnormal placentation did not differ significantly between the groups. Selected neonatal outcomes, including Apgar scores, cord pH, birth weight, and perinatal death, were similar between groups as well.
These findings suggest that the type of low transverse cesarean closure does not significantly affect the outcome of the next pregnancy.
确定单层或双层低位横切口剖宫产缝合方法是否会影响后续妊娠结局。
在先前报道的一项前瞻性试验中，906名女性被随机分配至单层或双层子宫缝合组。164名女性随后在我们机构妊娠并分娩（妊娠18周或更长时间）。通过查阅病历确定母婴结局，并在单层和双层缝合组之间进行比较。
在这164例后续分娩中，83例先前为单层缝合，而81例为双层缝合。这两组的人口统计学特征相似。19名女性（12%）接受了择期再次剖宫产且未经历分娩，其余145名经历了分娩。两组之间的产程长度、分娩方式、住院时间、分娩时的孕周以及子宫瘢痕裂开、绒毛膜羊膜炎、产后子宫内膜炎、出血、输血和胎盘异常的发生率无显著差异。选定的新生儿结局，包括阿氏评分、脐血pH值、出生体重和围产期死亡，两组之间也相似。
这些发现表明低位横切口剖宫产的缝合类型不会显著影响下一胎妊娠结局。
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