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在之前两次剖腹产的患者中计划剖腹产的时间
Noa Leybovitz-Haleluya1,2, Alla Saban3,4, Adi Yariv5
1Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Sagithaleluya@gmail.com.
Archives of gynecology and obstetrics
|March 20, 2024
概括
计划在38周怀孕时重复剖腹产,可以最大限度地减少新出现的手术,并改善母亲和婴儿的结果. 在38周之前的早产增加了并发症和更长的住院时间的风险.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 新生儿健康 新生儿健康
背景情况:
- 计划重复剖腹产 (CD) 的最佳时间仍然是一个临床辩论.
- 在分娩开始之前安排分娩可以降低子宫破裂的风险,但可能导致早产.
- 为计划重复CD定时,平衡孕产妇安全与胎儿成熟度至关重要.
研究的目的:
- 研究重复剖腹产时妊娠年龄对孕产妇和胎儿并发症的影响.
- 确定第三次剖腹产的理想时间,以优化结果.
主要方法:
- 从2020年2月到2022年1月,对624次单期第三次剖腹产 (CD) 的回顾性队列研究.
- 在分娩时,不同妊娠年龄组的孕妇和新生儿不良结果进行了比较.
- 后勤回归模型被用来调整混因素.
主要成果:
- 在怀孕37周的剖腹产 (CDs) 与38周的剖腹产相比,与新出现的CDs的比率更高有关.
- 在37周的分娩与明显更长的孕产妇和新生儿住院时间有关.
- 在37周的早产也与母亲和新生儿不良结果的复合相关.
结论:
- 在妊娠38周至38周+6天之间安排第三次剖腹产重复分娩与减少的紧急程序有关.
- 这种时间表也表明改善了母亲和新生儿的结果.
- 怀孕38周的选择性分娩似乎是第三次剖腹产的最佳窗口.
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