重复剖宫产对孕产妇及新生儿的影响

Effect of repeated cesarean section on pregnant women and neonates

目的:探讨重复剖宫产对孕产妇及新生儿的影响。方法:回顾性分析2010年1月-2012年12月间在Abdulla Mzee医院行重复剖宫产的孕妇132例,并根据剖宫产次数分为再次剖宫产组(repeated caesarean section group,RCS组,70例)和多次剖宫产组(multiple caesarean section group,MCS组,62例),同时随机选取同期行初次剖宫产手术分娩的60例作为初次剖宫产组(first caesarean section group,FCS组)进行对照。结果:①RCS及MCS组孕产妇年龄差异无统计学意义(P>0.05),但均高于FCS组,差异有统计学意义(P<0.05);三组平均孕次比较,差异有统计学意义(P<0.05),而平均孕周差异无统计学意义(P>0.05)。②产后出血发生率FCS组与MCS组间差异有统计学意义(P<0.05)。③FCS组无盆腹腔粘连发生,三组间差异有统计学意义(P<0.05)。④FCS组无子宫破裂发生,RCS组及MCS组各有3例,RCS组与MCS组间差异无统计学意义(P>0.05)。⑤伤口愈合不良的发生率再(多)次剖宫产组明显高于初次剖宫产组,多次剖宫产亦使膀胱损伤及新生儿窒息发生率升高。结论:再(多)次剖宫产显著增加妊娠并发症的发生率,也增加了新生儿窒息的发生率。行初次剖宫产时,一定要严格掌握好剖宫产指征,行重复剖宫产术,术前应做好充分的术前准备,术中谨慎操作,减少不必要的损伤。

Objective： To explore the effect of repeated cesarean section （RCS） on pregnant women and neonates. Methods： One hundred and thirty - two pregnant women receiving repeated cesarean section in Abdulla Mzee Hospital from January 2010 to December 2012 were analyzed retrospectively; and then they were divided into RCS group （70 pregnant women） and multiple cesarean section （MCS） group （62 pregnant women） according to the times of cesarean section; sixty patients receiving cesarean section for the first time during the same period were randomly selected as the first cesarean section （FCS） group. Results： There was no statistically significant difference in maternal age between RCS group and MCS group （ P 〉 0. 05 ）, but the maternal ages in RCS group and MCS group were statistically signifi- cantly higher than that in FCS group （ P 〈 0. 05 ） ; there was statistically significant difference in mean gravidity among the three groups （ P 〈 0.05 ）, but there was no statistically significant difference in mean gestational week among the three groups （ P 〉 0.05） . There was statisti- cally significant difference in the incidence rate of postpartum hemorrhage between FCS group and MCS group （ P 〈 0. 05 ） . No pelvic adhe- sion or abdominal adhesion occurred in FCS group, there was statistically significant difference among the three groups （ P 〈 0. 05 ） . No u- terine rupture occurred in FCS group, while in RCS group and MCS group, the number of pregnant women with uterine rupture were 3 and 3, respectively, there was no statistically significant difference between RCS group and MCS group （P 〉 O. 05） . The incidence rate of poor wound healing in RCS group was significantly higher than that in FCS group, RCS increased the incidence rates of bladder injul：~ and neonatal asphyxia. Conclusion： RCS increases the incidence rates of pregnancy complications and neonatal asphyxia. The indications of cesarean section should be grasped strictly when conducting cesarean section for the first time, to reduce unnecessary injury, it is important to prepare sufficiently before operation and operate cautiously during operation.