Long-term maternal morbidity associated with repeat cesarean delivery
Long-term maternal morbidity associated with repeat cesarean delivery
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DOI：
10.1016/j.ajog.2011.09.028
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发表时间：
2011-12-01
影响因子：
9.8
通讯作者：
Silver, Robert M.
中科院分区：
文献类型：
--
作者：
Clark, Erin A. S.;Silver, Robert M.
随着剖腹产率的持续增加，人们越来越担心剖腹产与长期孕产妇发病率之间的关系。观察证据表明，发病风险随着剖宫产次数的增加而增加。随后妊娠的主要孕产妇风险是植入性胎盘谱系疾病及其相关并发症。多次剖腹产史是这种情况的主要危险因素。剖腹产后怀孕也会增加其他类型胎盘异常、胎儿生长缓慢、早产和可能死产的风险。与剖腹产相关的慢性孕产妇疾病包括骨盆疼痛和粘连。不利的生殖影响可能包括生育能力下降以及自然流产和宫外孕的风险增加。临床医生和患者需要了解与剖宫产相关的长期风险，以便在确定第一胎和后续分娩的分娩方法时可以考虑这些风险。
Concern regarding the association between cesarean delivery and long-term maternal morbidity is growing as the rate of cesarean delivery continues to increase. Observational evidence suggests that the risk of morbidity increases with increasing number of cesarean deliveries. The dominant maternal risk in subsequent pregnancies is placenta accreta spectrum disorder and its associated complications. A history of multiple cesarean deliveries is the major risk factor for this condition. Pregnancies following cesarean delivery also have increased risk for other types of abnormal placentation, reduced fetal growth, preterm birth, and possibly stillbirth. Chronic maternal morbidities associated with cesarean delivery include pelvic pain and adhesions. Adverse reproductive effects may include decreased fertility and increased risk of spontaneous abortion and ectopic pregnancy. Clinicians and patients need to be aware of the long-term risks associated with cesarean delivery so that they can be considered when determining the method of delivery for first and subsequent births.