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帝王切開術에 關한 臨床的 考察

Clinical Survey of Cesarean Sections

대한산부인과학회지 1971년 14권 12호 p.15 ~ 22
李根洙/Lee, Geun Su
金在沼/朴洋緖/李相勳/Kim, Jai So/Park, Yang Suh/Lee, Sang Hoon

Abstract


A clinical survey has been made on 202 cases of c-section out of 2119 deliveries at the Department of Obstetrics & Gynecology, Korea -General Hospital from Nov. 1, 1968 to Feb. 28, 1971.
The clinical datas obtained were as follows.
1. The secton rate was 9.5%. It should be noted that the majority of cases were private patients.
2. In indication, the C.P.D was the most prevalent. Its rate was 32.2% and others were´ as follows; previous c-section 22.8%, malpresentation &4%. placenta previa 7.4%, fetal distress 5.4%, wanted c-section 5.4%, uterine dysfunction 3.9%, elderly primipara 3.0`, abruptio- placenta 2.5%, toxemia of pregnancy 2.0% and so on. The wanted c-section recently became an indication of c-section but further study in various aspects will be needed.
3. The incidence of primary c-section in multipara was 2.8% and . the C.P.D was the most frequent indication for primary c-section in multipara. We would like to emphasize the C.P.D as the complication in multipara not likely to be recognized until after considerable delay.
4. 25 cases(25.5% of c-section out of 98 cases of breech presentation were performed. In indication, borderline contracted pelvis was the most prevalent and its rate was 12%.
5. The types of operation; lower cervical transverse type was 97%, classical type was 1. 5% and cesarean hysterectomy was 1. 5%.
6. The rate of vaginal delivery following previous c-section was 6,1%; but the incidence of vaginal delivery following previous c-section may be increased according to the improvement of communication in order to get correct medical information and mobility for emergency surgery.
7. The rate of postoperative complication was 16.3%. The most frequent complication was puerperal morbidity.
8. There was one case of maternal death(O. 5%). This patientjcame in with eclamptic convulsion which was recovered by medical treatment. The c-section was performed on her 36 hrs following recovery because of unrippen cervix. She died of c.v.a. on the 5th postoperative day.

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