Unintentional transvesical caesarean section: incidence, risk factors, surgical technique and post-operative management
Unintentional transvesical caesarean section: incidence, risk factors, surgical technique and post-operative management
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DOI：
10.1016/j.ejogrb.2019.02.023
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发表时间：
2019-05-01
影响因子：
2.6
通讯作者：
Ghezzi, Fabio
中科院分区：
文献类型：
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作者：
Franchi, Massimo;Raffaelli, Ricciarda;Ghezzi, Fabio
目的：评估意外经膀胱剖腹产（UTV-CS）的发生率、风险因素、管理以及短期和长期结局，UTV-CS定义为通过双层全层膀胱切开术提取胎儿。检索了2013年1月至2017年12月期间所有UTV-CS的数据，检索了剖宫产（CS）期间膀胱损伤和膀胱修复的诊断在我们全面的计算机化的劳动和交付数据库和登记。排除了未归类为UTV-CS的伴有膀胱壁损伤的CS。数据分析包括产妇的病史，人口统计学和产科参数，关于CS，膀胱损伤的位置和扩展，以及短期和长期的孕产妇outcomes.Results：在28,822交付，7,616（26.42%）的详细信息CS。UTV-CS 3例，综合发病率为0.039%。我们提供了详细的报告的情况下，并描述了膀胱修复programmes. Conclusions（S）：这是第一个研究，评估UTV-CS的发病率。UTV-CS危险因素与轻度膀胱损伤相关因素一致。尽管CS期间膀胱损伤的发生率较低，但应始终考虑该并发症的风险。及时的诊断和手术修复似乎可以避免严重的并发症和恢复正常的泌尿功能，即使在UTV-CS。(C)2019爱思唯尔B. V.保留所有权利。
Objective(s): To assess incidence, risk factors, management, and short and long-term outcomes of unintentional transvesical caesarean section (UTV-CS) defined as any extraction of the fetus through a double full thickness bladder wall cystotomy.Study design: Data about all UTV-CS between January 2013 and December 2017 were retrieved searching the diagnosis of bladder injury and bladder repair during caesarean section (CS) in our comprehensive computerized labor and delivery database and register. CS with bladder wall injury not classified as UTV-CS were excluded. Data analysis included maternal history, demographics and obstetric parameters, details regarding CSs, bladder injury location and extension, and short- and long-term maternal outcomes.Results: Among 28,822 deliveries, 7,616 (26.42%) were CSs. Three cases of UTV-CS were identified with comprehensive incidence of 0.039%. We provided details of the reported cases and described bladder repair procedure.Conclusion(s): This is the first study that assessed the incidence of UTV-CS. UTV-CS risk factors are consistent with factors related to milder bladder injuries. The risk of bladder injury during CS should be always considered, despite the low incidence of this complication. Prompt diagnosis and surgical repair seem to allow avoiding severe complications and recovery of a normal urological function even in UTV-CS. (C) 2019 Elsevier B.V. All rights reserved.