第二产程剖宫产对母婴的影响

目的:探讨第二产程剖宫产对母婴的影响。方法:对2006年1月～2008年12月第二产程剖宫产128例资料进行回顾性分析,并与同期第一产程剖宫产514例为对照,分析比较两组的产后岀血率、术中出血量及术中术后并发症如:切口撕裂、产后岀血、术后病率、腹部切口愈合不良的发生率;新生儿并发症如:新生儿窒息、吸入性肺炎、颅内岀血的发生率。结果:第二产程组术中出血量及产后岀血的发生率明显高于第一产程组(P<0.05),术后病率及切口愈合不良的发生率也明显高于对照组(P<0.01);第二产程剖宫产新生儿窒息及吸入综合征、颅内出血等并发症与第一产程剖宫产相比明显增加(P<0.05)。结论:第二产程剖宫产较一般头位急症剖宫产对母婴更为不利,因此,在掌握适当指征,避免不必要剖宫产,降低剖宫产率的同时,应尽量避免第二产程剖宫产,减少母婴并发症。

Effect of cesarean section at second trimester of pregnancy on mothers and fetuses

Objective:To explore the effect of cesarean section at second trimester of pregnancy on mothers and fetuses.Methods:The clinical data of 128 cases receiving cesarean section at second trimester of pregnancy from January 2006 to December 2008 were analyzed retrospectively,and 514 cases receiving cesarean section at first trimester of pregnancy were selected as control group;the incidences of postpartum hemorrhage,the amounts of intraoperative blood loss and incidences of intraoperative and postoperative complications(uterus incision rupture,postpartum hemorrhage,postoperative morbidity,bad healing of abdominal incision),incidences of neonatal complications(neonatal asphyxia,respiratory pneumonia,intracranial hemorrhage) in the two groups were analyzed and compared.Results:The amount of intraoperative blood loss and incidence of postpartum hemorrhage in second trimester of pregnancy group were significantly higher than those in control group(P<0.05);the postoperative morbidity and incidence of bad healing of abdominal incision in second trimester of pregnancy group were significantly higher than those in control group(P<0.01);the incidences of neonatal asphyxia,respiratory pneumonia and intracranial hemorrhage in second trimester of pregnancy group were significantly higher than those in control group(P<0.05).Conclusion:Cesarean section at second trimester of pregnancy is harmful to mothers and fetuses compared with common acute cesarean section of head position,thus,cesarean section at second trimester of pregnancy should be avoided in order to reduce the complications of mothers and fetuses on the basis of grasping the indications of cesarean section,avoiding unnecessary cesarean section and reducing the rate of cesarean section.