Is human myometrial sampling at the time of cesarean delivery safe?
Is human myometrial sampling at the time of cesarean delivery safe?
复制标题
剖腹产时进行人类子宫肌层取样安全吗？
DOI：
10.1067/mob.2000.107920
复制
发表时间：
2000
影响因子：
9.8
通讯作者：
T. Siddiqi
中科院分区：
文献类型：
--
作者：
S. McElvy;M. Miodovnik;L. Myatt;J. Khoury;T. Siddiqi
目的
引发人类劳动的机制仍然未知，正在进行广泛的调查。分娩期和非分娩期患者的子宫肌层是研究分娩过程中发生的结构、细胞和分子变化的理想组织。本研究旨在确定剖宫产时子宫肌层取样是否会增加产妇发病率。
研究设计
这是一项前瞻性队列研究，包括118例研究患者和236例对照患者。在剖宫产时，从子宫横切口的上级边缘获取全层子宫肌层样本。收集人口统计学和标准手术发病率数据。所用统计方法包括单变量和多变量分析。
结果
研究组和对照组在年龄、妊娠、产次、出生体重和Apgar评分方面没有显著差异。对照组的术中失血量估计值更大（P <0.02）;然而，红细胞压积水平的变化（术前vs术后值）没有差异。产后6周内子宫内膜炎、伤口感染和静脉血栓形成的发生率无显著差异。当研究组和对照组患者被分为足月分娩、足月未分娩、早产分娩和早产未分娩类别并比较产妇发病率时，评估的任何结局指标仍无显著差异。
结论
根据我们的数据，无论孕龄和是否有分娩，剖宫产时子宫肌层取样不会增加母体的总体发病率。
OBJECTIVE
The mechanism for the initiation of human labor remains unknown and is under extensive investigation. Myometrium from patients in labor and not in labor is the ideal tissue to study structural, cellular, and molecular changes that occur during parturition. This study was designed to determine whether myometrial sampling at the time of cesarean delivery increases maternal morbidity.
STUDY DESIGN
This is a prospective cohort study including 118 study and 236 control patients. A full-thickness myometrial sample was obtained from the superior edge of a transverse uterine incision at the time of cesarean delivery. Demographics and standard surgical morbidity data were collected. Statistical methods used included univariate and multivariate analysis.
RESULTS
The study and control groups did not differ significantly with respect to age, gravidity, parity, birth weight, and Apgar scores. The estimated intraoperative blood loss was greater in the control group (P <.02); however, the change in hematocrit level (preoperative vs postoperative values) was not different. There were no significant differences in the rates of endometritis, wound infection, and venous thrombosis up to 6 weeks post partum. When study and control patients were stratified into term in labor, term not in labor, preterm in labor, and preterm not in labor categories and compared for maternal morbidity, there were still no significant differences for any of the outcome measures evaluated.
CONCLUSION
On the basis of our data, human myometrial sampling at cesarean delivery does not increase overall maternal morbidity, irrespective of gestational age and the presence or absence of labor.