Maternal and fetal mortality and complications associated with cesarean section deliveries in teaching hospitals in Asia

作者：Chongsuvivatwong Virasakdi^*; Bachtiar Hafni; Chowdhury Mahbub Elahi; Fernando Sunil; Suwanrath Chitkasaem; Kor anantakul Ounjai; Le Anh Tuan; Lim Apiradee; Lumbiganon Pisake; Manandhar Bekha; Muchtar Masrul; Nahar Lutfan; Nguyen Trong Hieu; Fang Pan Xiao; Prasertcharoensuk Witoon; Radnaabarzar Erdenetungalag; Sibuea Daulat; Than Kyu Kyu; Tharnpaisan Piangjit; Thach Tran Son; Rowe Patrick

来源：Journal of Obstetrics and Gynaecology Research, 2010, 36(1): 45-51.

DOI：10.1111/j.1447-0756.2009.01100.x

• cesarean section
• maternal complications
• neonatal complications
• neonatal mortality
• vaginal delivery

Aim:
To compare the mortality, morbidity of emergency and elective cesarean section with vaginal delivery among Asian teaching hospitals
Methods:
Hospital based prospective study at 12 centers of 9 countries.
Results:
12 591 vaginal deliveries, 3062 elective and 4328 emergency cesarean section were followed up to 5 days postpartum. Maternal deaths (95% CI) per 1000 births among vaginal deliveries being 0.47 (0.17, 1.03) was not significantly different from 0.31 (0.01, 1.73) of elective cesarean section and both rates were significantly lower than 2.87 (1.53, 4.91) per 1000 births of emergency section. The vaginal delivery group had significantly lower incidences of all major complication except significantly higher chance of secondary operations and non-significantly different risk for endometritis. Corresponding neonatal mortality per 1000 deliveries among the three groups were 7 (5.6, 8.6), 2.2 (0.9, 4.6) and 12.4 (9.3, 16.2) (P < 0.001). Vaginal delivery also had higher rates of severe asphyxia and palsy than elective cesarean section.
Conclusion:
Maternal complications were increased by cesarean delivery but elective section may reduce neonatal complication.

• 出版日期2010-2
• 单位河北医科大学