低社会经济国家重复剖宫产术粘连松解的意义一项初步研究

A. B. A. Mitwaly, A. Abbas
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引用次数: 0

摘要

剖宫产术后粘连的发生随重复剖宫产次数的不同而不同。据报道,交货时间随着CS数量的增加而增加。材料和方法:这是一项2012年8月至2015年8月在Assiut妇女健康医院进行的前瞻性队列研究,目的是评估在胎儿分娩前或分娩后进行粘连松解术对当前CS期间孕产妇发病率和下一节的复发率的影响。在CS中的粘连溶解避免使用抗粘连物质,这是昂贵的,在我们的低收入社会是不可获得的。结果:50例患者纳入研究。粘连类型以网膜、膀胱和子宫粘连为主,形成前腹壁带。所有病例均出现子宫膀胱粘连。粘连松解期间未发生产妇发病。随访3年。粘连松解术后再次粘连的比例仅为2例(4%),且均为网膜粘连。结论:在我国社会经济水平较低的国家,粘连松解术在重复粘连中的应用具有上升曲线的经验,且无产妇并发症。剖宫产术后粘连的发生随重复剖宫产次数的不同而不同。据报道,交货时间随着CS数量的增加而增加。材料和方法:这是一项2012年8月至2015年8月在Assiut妇女健康医院进行的前瞻性队列研究,目的是评估在胎儿分娩前或分娩后进行粘连松解术对当前CS期间孕产妇发病率和下一节的复发率的影响。在CS中的粘连溶解避免使用抗粘连物质,这是昂贵的,在我们的低收入社会是不可获得的。结果:50例患者纳入研究。粘连类型以网膜、膀胱和子宫粘连为主,形成前腹壁带。所有病例均出现子宫膀胱粘连。粘连松解期间未发生产妇发病。随访3年。粘连松解术后再次粘连的比例仅为2例(4%),且均为网膜粘连。结论:在我国社会经济水平较低的国家,粘连松解术在重复粘连中的应用具有上升曲线的经验,且无产妇并发症。
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Implications of adhesiolysis during repeat cesarean section in low socioeconomic countries; A pilot study
Introduction: Adhesions developed after cesarean sections (CS) vary according to the number of repeat section. Delivery times were reported to be increase with increased number of CS. Material and Methods: This is a prospective cohort study done in Assiut Women Health Hospital from August 2012 to August 2015 to evaluate the implications of doing adhesiolysis at CS either before delivery of the fetus or after that on maternal morbidity during current CS and recurrence rate in next sections. Adhesiolysis during CS avoid the use of anti-adhesion substances which is costly and not available in our low income society. Results: Fifty patients were included in the study. The dominant type of adhesion was omental, bladder and uterine adhesions forming bands with anterior abdominal wall. The uterovesical adhesion was present in all cases. No maternal morbidity occurred during adhesiolysis. Follow up of those patients were cone for 3 years. The percentage of adhesions in the next CS after this adhesiolysis was only 2 cases (4%) and both cases were omental adhesion s. Conclusions: The use of adhesiolysis in repeat CS adhesions with ascending curve of experience is essential in our low socioeconomic countries and associated with no maternal complications.  Introduction: Adhesions developed after cesarean sections (CS) vary according to the number of repeat section. Delivery times were reported to be increase with increased number of CS. Material and Methods: This is a prospective cohort study done in Assiut Women Health Hospital from August 2012 to August 2015 to evaluate the implications of doing adhesiolysis at CS either before delivery of the fetus or after that on maternal morbidity during current CS and recurrence rate in next sections. Adhesiolysis during CS avoid the use of anti-adhesion substances which is costly and not available in our low income society. Results: Fifty patients were included in the study. The dominant type of adhesion was omental, bladder and uterine adhesions forming bands with anterior abdominal wall. The uterovesical adhesion was present in all cases. No maternal morbidity occurred during adhesiolysis. Follow up of those patients were cone for 3 years. The percentage of adhesions in the next CS after this adhesiolysis was only 2 cases (4%) and both cases were omental adhesion s. Conclusions: The use of adhesiolysis in repeat CS adhesions with ascending curve of experience is essential in our low socioeconomic countries and associated with no maternal complications.
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来源期刊
Thai Journal of Obstetrics and Gynaecology
Thai Journal of Obstetrics and Gynaecology Medicine-Obstetrics and Gynecology
CiteScore
0.40
自引率
0.00%
发文量
3
审稿时长
24 weeks
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