二次剖宫产术孕妇及新生儿并发症发生情况分析

Maternal and neonatal complication of repeated caesarean section

目的:通过对照研究,探讨二次剖宫产术孕妇及新生儿并发症发生情况分析。方法:选择二次妊娠剖宫产孕妇272例(A组),二次妊娠阴道分娩孕妇300例(B组),初次妊娠剖宫产分娩的孕妇350例(C组)。对三组孕妇临床资料进行分析,并均进行至少1年的随访。比较三组妊娠孕妇不同分娩方式近、远期并发症情况及新生儿并发症。结果:(1)二次妊娠剖宫产孕妇中有70例(25.7%)发生术后并发症,二次妊娠阴道分娩孕妇有9例(3.0%)发生术后并发症,初次妊娠剖宫产分娩孕妇有42例(12.0%)发生术后并发症,三组并发症发生率组间比较差异显著(P<0.05)。(2)A、C两组孕妇的近期并发症(产后出血、切口感染、产后发热)及远期并发症(慢性盆腔炎、盆腔粘连)发生率均显著高于B组,差异具有统计学意义(P<0.05)。且A组孕妇的近期并发症(产后出血、切口感染、产后发热)及远期并发症(盆腔粘连)发生率均显著高于C组,差异具有统计学意义(P<0.05)。(3)A组羊水粪染、新生儿窒息及胎儿宫内窘迫的比例均显著高于B组及C组,差异具有统计学意义(P<0.05)。结论:二次妊娠剖宫产可显著增加产妇术中、术后并发症及新生儿并发症,临床医师应尽量避免无指征剖宫产,有效降低剖宫产率。

Objectives： To explore the maternal and neonatal complications of repeated caesarean section through comparative study. Methods： 272 pregnant women with repeated cesarean section （group A）, 300 preg- nant women with repeated vaginal delivery （group B）, and 350 pregnant women with the first cesarean section deliv- ery （ group C） were selected. The clinical data of pregnant women in the three groups were analyzed, and a follow - up of at least one year was conducted. The long - term and short - term maternal complications and neonatal compli- cations of the three groups were compared. Results： 1. 70 cases （25.7%）, 9 cases （3.0%） and 42 cases （ 12. 0% ） had postoperative complications in group A, B and C respectively, with significant difference in the inci- dence between each two groups （ P 〈 0.05 ）. 2. The incidence of short - term complications （ postpartum hemor- rhage, infection of incision, postpartum fever） and the long -term complications （chronic pelvic inflammation, pel- vic adhesion） of group A and C was significantly higher than that of group B, with statistically significant difference （P 〈 0. 05）. The incidence of short - term and long - term complications of group A was significantly higher than that of group C, with statistically significant difference （P 〈 0.05）. 3. The proportions of meconium stained amni- otic fluid, asphyxia of newborn and fetal distress of group A were significantly higher than those of group B and C, with statistically significant difference （P 〈0.05）. Conclusion： Repeated cesarean section can significantly in- crease the incidence of maternal intraoperative and postoperative complications and neonatal complications. Clini- cians should avoid cesarean section of no indications, to reduce the cesarean section rate.