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首页> 外文期刊>BJOG: an international journal of obstetrics and gynaecology >Impact of timing of delivery on maternal and neonatal outcomes for women after three previous caesarean deliveries; a secondary analysis of the caesarean section registry
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Impact of timing of delivery on maternal and neonatal outcomes for women after three previous caesarean deliveries; a secondary analysis of the caesarean section registry

机译：在以前的三次剖腹产后妇女交付时间对妇女和新生儿结果的影响; 剖腹产注册表的次要分析

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Background As more women are presenting with three previous caesarean deliveries (CD), providers may suggest early term delivery as a means to avoid the risk of spontaneous labour and associated maternal morbidity. Objective To determine whether early term delivery is associated with lower maternal and neonatal morbidity for women with three previous CD. Study design Secondary analysis of a prospective registry of CD at 19 US academic centres from 1999 to 2002. Population Women with three previous CD undergoing scheduled or emergent delivery with live, singleton gestations 37-41+ weeks of gestation were included. Women with non-low transverse incisions, antepartum stillbirth, previous myomectomy, fetal anomalies, more or fewer than three previous CD or attempting trial of labour after caesarean section were excluded. Methods Gestational age was categorised by week. We fitted logistic regression models to adjust for clinically relevant or statistically significant confounders. Main outcome measures The primary and secondary outcomes were composites, respectively, of maternal and neonatal morbidity. Results In all, 821 women met the inclusion criteria; maternal morbidity composite occurred in 9.86% and neonatal morbidity occurred in 10.5%. After adjusting for confounding variables, maternal and neonatal morbidity occurred least frequently at 39 weeks. Conclusions In women with three previous CDs, adverse maternal outcomes do not increase with increasing gestational age beyond 37 weeks but early term elective repeat CDs are associated with higher neonatal morbidity. Elective delivery of women with three previous CD at 39 weeks of gestation is safe in the absence of maternal or fetal indications for early term delivery.
机译：背景技术随着更多女性呈现三个以前的剖腹产（CD），提供商可能会提出早期交付作为一种方法，以避免自发劳动和相关的母体发病率的风险。目的判断早期递送是否与患有三个先前CD的妇女的孕妇和新生儿发病率有关。 1999年至2002年美国学术中心的第1999至2002年兼学习中心预期登记处的研究设计次要分析。有三个以前CD的人口妇女正在纳入预定或紧急送货，包括妊娠的妊娠37-41 +周。患有非低横切切口的妇女，患儿死土，先前的肌瘤切除术，胎儿异常，更多或少于先前的CD或试图在剖腹产后试图劳动试验。方法妊娠年龄按周分类。我们拟合了物流回归模型，以调整临床相关或统计上显着的混淆。主要结果测量母体和新生儿发病率的主要和二次结果分别是复合材料。结果，821名妇女符合纳入标准;母体发病率综合发生在9.86％，新生儿发病发生10.5％。调整混淆变量后，母体和新生儿发病率最少在39周内发生。结论患有三个先前CD的妇女，不断增长的孕产妇结果不增加37周，但早期选择性重复CD与新生儿发病率较高有关。在妊娠39周的妊娠39周内，在妊娠的39周内选择妇女的妇女在没有母体或胎儿的早期交付的情况下是安全的。

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