The risk and anesthetic management of scar uterus undergoing cesarean section
- VernacularTitle:瘢痕子宫剖宫产的风险与麻醉处理
- Author:
Xiaoqing CHAI
;
Kunzhou CHEN
- Publication Type:Journal Article
- Keywords:
Scar uterus;
Cesarean section;
Epidural anesthesia
- From:
The Journal of Clinical Anesthesiology
2009;25(12):1020-1022
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risks and anesthetic management of scar uterus undergoing cesarean section.MethodsOne hundred pregnant women(aged 24-43 years old)with scar uterus underwent cesarean section.Epidural anesthesia was used in 90 cases(group A)and general anesthesia in 10 cases(group B).The monitorings included ECG,BP,HR and SpO_2.CVP was measured in the high risk cases.The time from skin incision tO neonatal delivery(I-D).the time from uterine incision to delivery(U-D),and Apgar scores of neonates were recorded.Results Incomplete blockade was seen in 20 cases(22％).The I-D time was shorter in group B than that in group A[(7.5±2.0)min vs.(12.3±2.6)min](P<0.01).Intraoperative hypotension occurred in 32 cases (32％).Neonatal asphyxia happened in 21 cases(21%).Apgar scores of 11 neonatals werc less than 3,of whom 5 neonates died.Apgar scores were 4 to 7 in 10 cases,8 to 10 in 79 cases.Subtotal uterectomy was performed in 2 cases.Repair of injuried bladder had to be done in one case.Intraoperative huge bleeding took place in 15 cases.Conclusion The scar uterus undergoing cesarean section has a high risk for mothers and neonates.The incidence of incomplete epidural blockade is higher.Effectively preventing and managing the risk factors are the keys for reducing maternal and neonatal complications and mortality.
