急诊和重复剖宫产时膀胱损伤率增加

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY
Ali S Khalil, Suneet Flora, Karen Hagglund, Muhammad Aslam
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引用次数: 0

摘要

目的:膀胱损伤是剖宫产术的并发症之一。据报道,膀胱损伤的总发生率为CS的0.22-0.44%。然而,目前尚不清楚是什么因素影响了这一比率。本研究的目的是确定在为产科并发症高危人群服务的大型大都市医院,计划CS和急诊CS以及原发CS和重复CS的膀胱损伤率是否存在差异。此外,还调查了膀胱损伤后泌尿外科会诊的使用情况,以及人口统计学因素和分娩特征是否影响膀胱损伤率。材料和方法:从2013年1月1日到2020年12月31日,共审查了8488份记录(4292份初次CS和4196份重复CS)。计算膀胱损伤的发生率,并记录术中泌尿/泌尿生殖科会诊率。然后比较膀胱损伤与术中泌尿/泌尿生殖系统咨询之间的关系,以及膀胱损伤与母亲年龄、体重指数(BMI)和胎龄之间的关系。结果:与原发性CS相比,重复性CS发生膀胱损伤的风险显著增加(p=0.01)。与常规CS相比,急诊CS发生膀胱伤害的风险也显著增加(p=0.04)。膀胱损伤组与无膀胱损伤组相比,术中泌尿系/泌尿科会诊明显更高(结论:这些结果补充了现有的证据,即膀胱损伤是CS中一种罕见的并发症,与原发性或计划性CS相比,在接受重复性或紧急性CS的女性中可能更频繁发生。鉴于重复性或急诊性CS的风险增加,患者应意识到这些风险,外科医生应在术中仔细考虑,密切术后随访。)低位。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Increased bladder injury rate during emergency and repeat cesarean section

Increased bladder injury rate during emergency and repeat cesarean section

Increased bladder injury rate during emergency and repeat cesarean section

Increased bladder injury rate during emergency and repeat cesarean section

Objective: Bladder injury is one of the complications of cesarean section (CS). It is reported that the overall incidence of bladder injury is 0.22-0.44% of CS. It is, however, unclear what factors influence this rate. The aim of this study was to determine if there is a difference in bladder injury rate between scheduled and emergency CS, as well as in primary and repeat CS at a large metropolitan hospital that serves a population at high risk for obstetric complications. In addition, the use of urology consultation following bladder injury and whether demographic factors and labor characteristics affect the rate of bladder injury were investigated.

Material and methods: A total of 8,488 records were reviewed (4,292 primary CS and 4,196 repeat CS) from January 1, 2013 to December 31, 2020. The incidence of bladder injury was calculated and the rate of intraoperative urology/urogynecology consultation was recorded. Then the association between bladder injury and intraoperative urology/urogynecology consultation and between bladder injury and maternal age, body mass index (BMI), and gestational age were compared.

Results: There was a significant increase in risk of bladder injury in repeat CS versus primary CS (p=0.01). There was also a significant increase in risk of bladder injury in emergency CS versus scheduled CS (p=0.04). Intraoperative urogynecology/urology consultations were significantly higher in the bladder injury versus no bladder injury groups (p<0.0001). Both emergency CS and repeat CS are predictors of bladder injury with odd ratios of 5.7 and 7.4, respectively.

Conclusion: These results add to the existing evidence that bladder injury is a rare complication in CS that may occur more often in women undergoing repeat or emergency CS than primary or scheduled CS. Given that the risk increases with repeat or emergency CS, patients should be made aware of such risks and surgeons should make careful intraoperative considerations with close postoperative follow-ups.

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来源期刊
CiteScore
2.40
自引率
7.10%
发文量
56
期刊介绍: Journal of the Turkish-German Gynecological Association is the official, open access publication of the Turkish-German Gynecological Education and Research Foundation and Turkish-German Gynecological Association and is published quarterly on March, June, September and December. It is an independent peer-reviewed international journal printed in English language. Manuscripts are reviewed in accordance with “double-blind peer review” process for both reviewers and authors. The target audience of Journal of the Turkish-German Gynecological Association includes gynecologists and primary care physicians interested in gynecology practice. It publishes original works on all aspects of obstertrics and gynecology. The aim of Journal of the Turkish-German Gynecological Association is to publish high quality original research articles. In addition to research articles, reviews, editorials, letters to the editor, diagnostic puzzle are also published. Suggestions for new books are also welcomed. Journal of the Turkish-German Gynecological Association does not charge any fee for article submission or processing.
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