제왕절개술의 임상적 고찰 = Clinical Study in Cesarean Section

국문 초록 (Abstract)

1978년 1월 1일부터 1980년 12월 31일까지 만 3년간 국립원호병원 산부인과에 입원하여 1000gm 이상의 태아를 분만한 1,481예중 제왕절개술에 의한 분만수는 251예로 이중 임상기록이 충실한 248예와 쌍태아 5예를 포함하여 253예의 신생아 및 사산아를 임상적으로 분석하여 다음과 같은 결과를 얻었기에 보고하는 바이다. 1. 제왕절개술의 빈도는 16.7%이었다. 2. 제왕절개술의 적응증은 C.P.D.가 34.3%로써 가장 높았고 기왕제왕절개술이 24.2%, 태위이상이 13.3%등의 순위이었다. 3. 제왕절개술식은 자궁협부횡절개가 94.85로 대부분을 차지하였다. 4. 마취방법은 전신마취가 98.4%이고 요추마취는 1.6%이었다. 5. 제왕절개술과 병행된 수술은 난관결찰술이 77.5%이었고 다음이 충수절제술이 43.8%이었다. 6. 모성사망율은 없으며 모성이환율은 22.9%이었다. 7. 분만진통시간별 모성이환율은 분만진행이 12시간이상 경과된 군에서 현저히 증가함을 관찰하였다. 8. 양수파막시간별 모성이환율은 파막된 시간이 길수록 높았으며 파막된 후 25시간이 경과된 군에서 현저히 증가하였다. 9. 주산기 사망의 백분율은 8.6%이었다.

다국어 초록 (Multilingual Abstract)

cesarean section has made a major contribution to improved perinatal outcome in the last few years. However cesarean section is still associated with greater morbidity for mothers. An attempt was made to evaluate the trend of cesarean section, maternal mortality and morbidity and perinatal outcome. From 1, January 1978 to 31, December 1980, 248 cases of cesarean section were analysed statistically at dept. of obstet. and gynecol., national veterans hospital. The results were as follows; 1. Cesarean section rate was 16.7%. 2. The indications of cesarean section were cephalopelvic disproportion(34.3%), previous cesarean section(24.2%) and malpresentation(13.3%) in order. 3. In the types of operation, low cervical cearean section was most common(94.8%). 4. In the anesthesia, general anesthesia was 98.4% and spinal anesthesia was 1.6%. 5. In the incidental operations with cesarean section, there were tubal ligations(77.5%) and appendectomy(43.8%). 6. It was found that maternal mortality was a nothing and the morbidity was 22.9%. 7. Maternal morbidity was increased as the duration of labor was prolonged. In the group of over 12 hours after onset of labor, it was markedly increased. 8. Maternal morbidity was increased as the duration of rupture of membrane was extended. In the group of over 25 hours after rupture of membrane, it was markedly increased then the group of less then 25 hours. 9. Perinatal mortality was 8.6%.