不同麻醉方式对合并前置胎盘伴植入二胎剖宫产母婴结局的影响

目的 探讨不同麻醉方式对合并前置胎盘伴植入二胎剖宫产母婴结局的影响.方法 55例合并前置胎盘伴植入二胎剖宫产单胎产妇,按照麻醉方式不同分为全身麻醉组(18例)与硬膜外麻醉组(37例).全身麻醉组产妇剖宫产术中采用全身麻醉,硬膜外麻醉组产妇剖宫产术中采用硬膜外麻醉.对比两组产妇结局指标、新生儿结局指标.结果 硬膜外麻醉组...

Effects of different modes of anesthesia on maternal and neonatal outcomes in puerperas with placenta previa and accreta undergoing cesarean section for second birth

Objective To discuss the effects of different modes of anesthesia on maternal and neonatal outcomes in puerperas with placenta previa and accreta undergoing cesarean section for second birth.Methods 55 singleton puerperas with placenta previa and accreta undergoing cesarean section for second birth were divided into general anesthesia group(18 cases)and epidural anesthesia group(37 cases)based on different modes of anesthesia.Puerperas in the general anesthesia group received general anesthesia in the cesarean section;while puerperas in the epidural anesthesia group received epidural anesthesia in the cesarean section.The maternal outcome indicators and neonatal outcome indicators were compared between the two groups.Results The epidural anesthesia group had intraoperative blood loss of(4.15±2.51)U and intraoperative crystalloid fluid dosage of(1387.25±326.47)ml,which were less than(5.86±2.45)U,(1637.25±341.15)ml of the general anesthesia group,respectively;the epidural anesthesia group had surgery time of(73.16±31.26)min and postpartum hospital stay of(6.35±3.46)d,which were shorter than(99.34±44.25)min,(10.57±6.45)d,respectively;and the differences were statistically significant(P<0.05).The epidural anesthesia group had a postpartum hemorrhage rate of 21.62%,an implementation rate of surgical hemostasis measures of 10.81%,a hysterectomy rate of 2.70%and a postpartum transfer rate to intensive care unit(ICU)of 0,which were lower than 72.22%,33.33%,27.78%and 11.11%of the general anesthesia group,respectively;and the differences were statistically significant(P<0.05).The premature delivery rate of the epidural anesthesia group was 13.51%,which was lower than 38.89%of general anesthesia group,and the difference was statistically significant(P<0.05).Conclusion The effect of applying epidural anesthesia in puerperas with placenta previa and accreta undergoing cesarean section for second birth is more obvious than that of applying general anesthesia.The epidural anesthesia may reduce the impact of anesthesia on maternal and neonatal outcomes.Therefore,epidural anesthesia should be used as much as possible during the cesarean section.