van Ham M A, van Dongen P W, Mulder J
Department of Gynaecology and Obstetrics, University Hospital Nijmegen St Radboud, The Netherlands.
Eur J Obstet Gynecol Reprod Biol. 1997 Jul;74(1):1-6. doi: 10.1016/s0301-2115(97)02725-5.
This study was performed to assess the intra-operative surgical complications and postoperative maternal morbidity rate of caesarean section.
A total of 2647 women, delivered by caesarean section in our department between 1983 and 1992, were studied retrospectively. Three caesarean section groups were formed: (1) primary elective, (2) primary acute, without any effort to deliver vaginally, and (3) secondary acute, due to a failed vaginal delivery. The Student's-t-, Fisher-exact- and chi 2-test were used for statistical analysis.
The overall maternal intra-operative complication rate was 14.8%. The most common complications were lacerations of the uterine corpus (10.1%) and bloodloss > or = 1000 ml (7.3%). The complication rate of the secondary group (23.4%) was significantly higher (p < 0.001) compared to both primary groups (7.4%). The overall maternal postoperative morbidity rate was 35.7%. Fever (24.6%), bloodloss between 1000 and 1500 ml (4%), haematoma (3.5%) and urinary tract infections (3.0%) were the most frequent complications. The primary elective group showed significantly (p < 0.001) lower major (2.6%) and minor (23.7%) complication rates compared to the emergency groups (major 5.2%, minor 34%).
Emergency caesarean sections carried the greatest risks regarding maternal complications compared to elective procedures.
本研究旨在评估剖宫产术中手术并发症及术后产妇发病率。
回顾性研究了1983年至1992年间在我科行剖宫产的2647名妇女。形成了三组剖宫产组：（1）初次择期剖宫产；（2）初次急症剖宫产，未尝试经阴道分娩；（3）二次急症剖宫产，因阴道分娩失败。采用Student's-t检验、Fisher精确检验和卡方检验进行统计分析。
产妇术中总体并发症发生率为14.8%。最常见的并发症是子宫体裂伤（10.1%）和失血≥1000ml（7.3%）。二次剖宫产组的并发症发生率（23.4%）显著高于两个初次剖宫产组（7.4%）（p<0.001）。产妇术后总体发病率为35.7%。发热（24.6%）、失血1000至1500ml（4%）、血肿（3.5%）和尿路感染（3.0%）是最常见的并发症。与急症剖宫产组（严重并发症5.2%，轻微并发症34%）相比，初次择期剖宫产组的严重（2.6%）和轻微（23.7%）并发症发生率显著更低（p<0.001）。
与择期剖宫产相比，急症剖宫产产妇发生并发症的风险最大。
