剖宫产次数对母婴的影响  

The influence of cesarean section frequency on maternal and infant

作　　者：张丽姣 孟茜[1] 姚军 ZHANG Lijiao;MENG Qian;YAO Jun(Department of Obstetrics,Lianyungang Maternal and Child Health Hospital,Lianyungang 222000;Department of Obstetrics and Gynecology,Lianyungang Maternal and Child Health Hospital,Lianyungang 222000)

机构地区：[1]连云港市妇幼保健院产科,江苏连云港222000 [2]连云港市妇幼保健院妇产科,江苏连云港222000

出　　处：《当代医药论丛》2022年第7期11-15,共5页

基　　金：连云港市妇幼保健院青年英才培养基金资助项目(ky202005);上海市重点实验室开放课题基金资助项目(17DZ2273600)。

摘　　要：目的:探讨剖宫产次数对母婴的影响。方法:选择2018年10月至2020年12月在连云港市妇幼保健院进行剖宫产手术的2636例孕产妇(其中因非医学指征行第1次剖宫产手术的孕产妇有324例,行第2次剖宫产手术的孕产妇有1897例,行第3次剖宫产手术的孕产妇有385例,行第4次剖宫产手术的孕产妇有30例)作为研究对象。对这些孕产妇及其新生儿的临床资料进行对比分析,总结剖宫产次数对母婴的影响。结果:随着剖宫产次数的增加,孕产妇前置胎盘的发生率、手术的时间、术中的出血量、产后出血的发生率、盆腹腔粘连的发生率、产科重症监护(MICU)率、新生儿重症监护(NICU)率均增加,且其新生儿的胎龄逐渐减小,不同剖宫产次数(1次、2次、3次、4次)孕产妇的上述指标相比差异有统计学意义(P<0.05),并呈现出一定的线性关系。结论:重复性剖宫产对母婴均有不利的影响,且存在一定的量效关系,因此临床上应尽量降低非医学指征的剖宫产率,提高剖宫产术后再次妊娠女性的阴道试产率。Objective:To investigate the influence of cesarean section frequency on maternal and infant.Methods:Methods from October 2018 to December 2020,2636 cases of pregnant women underwent cesarean section in Lianyungang Maternal and Child Health Hospital(including 324 cases of the first cesarean section due to non-medical indications,1897 cases of the second cesarean section and 385 cases of the third cesarean section)were selected.30 pregnant women underwent the fourth cesarean section)as the research object.The clinical data of thes e pregnant women and their newborns were compared and analyz ed,and the impact of cesarean section times on mothers and infants was summarized.Results:With the increase of the number of cesarean section,the incidence of placenta previa,operation time,intraoperative blood loss,postpartum hemorrhage,pelvic and abdominal adhesion,obstetric intensive care(MICU)rate,neonatal intensive care(NICU)rate increased,and the gestational age of the newborn decreased gradually.There were statistically significant differences in the above indicators among pregnant women with different cesarean delivery times(1,2,3 and 4 times)(P<0.05),and there was a certain linear relationship.Conclusion:Repetitive cesarean section has adverse effects on both mother and baby,and there is a certain dose-effect relationship,so the rate of non-medical indication of cesarean section should be re duced as far as possible in clinical practice,and the rate of vaginal trial labor of women with second pregnancy after cesarean secti on should be improved.

关 键 词：剖宫产 疤痕子宫 产后出血 前置胎盘 盆腹腔粘连 

分 类 号：R719.8[医药卫生—妇产科学]