法国门诊剖宫产(FAUCS)后的产妇和新生儿结局:一项前瞻性研究的初步结果

IF 1
Daniel Wolder, Anna Blazuk-Fortak, Agata Michalska, Karol Bielasik, Aleksandra Gladys-Jakubczyk, Piotr Kaczmarek, Grzegorz Swiercz, Luka Velemir
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摘要

目的:法国门诊剖宫产术(FAUCS)是一种腹膜外剖宫产术,旨在提高产妇恢复和降低术后发病率。虽然早期的试验表明比传统的剖宫产术(CS)有一定的好处,但实际数据仍然很少。本研究在前瞻性队列中比较了FAUCS和CS之间的孕产妇和新生儿结局,重点是围手术期恢复。材料和方法:本前瞻性研究纳入2023年9月至2024年12月期间足月(37-40 Hbd)行选择性剖宫产术(FAUCS或CS)的妇女。产妇结局包括手术时间、出血量、活动时间、食物口服摄入量和开始母乳喂养。新生儿结局包括出生体重、Apgar评分和脐带动脉ph。比较采用t检验、Wilcoxon检验或卡方检验(p < 0.05; R为分析)。结果:纳入66例患者(FAUCS: 30; CS: 36)。基线产妇或产科特征具有可比性。在胎龄和出生体重方面没有发现差异。新生儿脐带pH值略低(7.33±0.07 vs 7.36±0.06,p = 0.009)。Apgar评分无差异。FAUCS与手术时间延长(30.7±4.1 min vs 26.4±10.3 min, p = 0.006)相关,但显著加快了动员,食物口服摄入和母乳喂养(均p < 0.001)。在FACUS中,基底压力较少(p < 0.001),器械辅助更频繁(p < 0.001)。弱阿片类药物的使用也较低(p = 0.036)。住院时间也差不多。结论:FAUCS似乎可以在不影响孕产妇或新生儿预后的情况下促进早期康复,支持在特定患者中使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Maternal and neonatal outcomes following French Ambulatory Cesarean Section (FAUCS): preliminary results of a prospective study.

Objectives: The French Ambulatory Cesarean Section (FAUCS) is an extraperitoneal cesarean technique aimed at enhancing maternal recovery and reducing postoperative morbidity. While early trials suggest certain benefits over conventional cesarean section (CS), real-world data remains scarce. This study compares maternal and neonatal outcomes between FAUCS and CS in a prospective cohort, with emphasis on perioperative recovery.

Material and methods: This prospective study included women undergoing elective cesarean section (FAUCS or CS) at term (37-40 Hbd) between September 2023 and December 2024. Maternal outcomes included surgery duration, blood loss, time to mobilization, food oral intake, and initiation of breastfeeding. Neonatal outcomes included birth weight, Apgar scores, and umbilical cord arterial pH. Comparisons used t-tests, Wilcoxon tests, or Chi-square tests (p < 0.05; analysis in R).

Results: Sixty-six patients were included (FAUCS: 30; CS: 36). Baseline maternal or obstetric characteristics were comparable. No differences were found in gestational age or birthweight. FAUCS neonates had marginally lower umbilical pH (7.33 ± 0.07 vs 7.36 ± 0.06, p = 0.009). No difference was found in Apgar scores. FAUCS was associated with longer surgery (30.7 ± 4.1 min vs 26.4 ± 10.3 min, p = 0.006), but significantly faster mobilization, food oral intake, and breastfeeding (all p < 0.001). Fundal pressure was used less often (p < 0.001), and instrumental assistance more frequently (p < 0.001) in FACUS. The use of weak opioids was also lower (p = 0.036). The hospital stay was similar.

Conclusions: FAUCS appears to enhance early recovery without compromising maternal or neonatal outcomes, supporting its use in select patients.

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