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目的:探讨重复剖宫产对孕产妇及新生儿的影响。方法:回顾性分析2010年1月-2012年12月间在Abdulla Mzee医院行重复剖宫产的孕妇132例,并根据剖宫产次数分为再次剖宫产组(repeated caesarean section group,RCS组,70例)和多次剖宫产组(multiple caesarean section group,MCS组,62例),同时随机选取同期行初次剖宫产手术分娩的60例作为初次剖宫产组(first caesarean section group,FCS组)进行对照。结果:①RCS及MCS组孕产妇年龄差异无统计学意义(P>0.05),但均高于FCS组,差异有统计学意义(P<0.05);三组平均孕次比较,差异有统计学意义(P<0.05),而平均孕周差异无统计学意义(P>0.05)。②产后出血发生率FCS组与MCS组间差异有统计学意义(P<0.05)。③FCS组无盆腹腔粘连发生,三组间差异有统计学意义(P<0.05)。④FCS组无子宫破裂发生,RCS组及MCS组各有3例,RCS组与MCS组间差异无统计学意义(P>0.05)。⑤伤口愈合不良的发生率再(多)次剖宫产组明显高于初次剖宫产组,多次剖宫产亦使膀胱损伤及新生儿窒息发生率升高。结论:再(多)次剖宫产显著增加妊娠并发症的发生率,也增加了新生儿窒息的发生率。行初次剖宫产时,一定要严格掌握好剖宫产指征,行重复剖宫产术,术前应做好充分的术前准备,术中谨慎操作,减少不必要的损伤。
Objective: To investigate the impact of repeated cesarean section on pregnant women and newborns. Methods: Retrospective analysis of 132 pregnant women with repeated cesarean section at Abdulla Mzee Hospital from January 2010 to December 2012 were divided into repeated caesarean section group (RCS group) according to the number of cesarean section , 70 cases) and multiple caesarean section group (MCS group, 62 cases). At the same time, 60 cases undergoing the first cesarean section at the same time were randomly selected as the first caesarean section group FCS group) for comparison. Results: ① There was no significant difference in the age of pregnant women between RCS and MCS group (P> 0.05), but both of them were higher than FCS group (P <0.05). The average gestational age of the three groups were statistically significant (P <0.05), while the average gestational age difference was not statistically significant (P> 0.05). The incidence of postpartum hemorrhage between FCS group and MCS group was statistically significant (P <0.05). ③FCS group no pelvic adhesions, the difference between the three groups was statistically significant (P <0.05). There was no uterine rupture in FCS group, 3 cases in RCS group and MCS group, but no significant difference between RCS group and MCS group (P> 0.05). ⑤ The incidence of poor wound healing again (more) times the cesarean section was significantly higher than the first cesarean section, multiple cesarean section also makes the bladder injury and neonatal asphyxia increased incidence. CONCLUSIONS: Cesarean section (s) significantly increased the incidence of pregnancy complications and also increased the incidence of neonatal asphyxia. The line of the first cesarean section, we must strictly control the indications of cesarean section, repeat cesarean section, preoperative and adequate preoperative preparation should be done, intraoperative cautious operation to reduce unnecessary damage.