제왕절개술에 대한 임상적 고찰 = Clinical Study of Cesarean Section

다국어 초록 (Multilingual Abstract)

In recent Years, the use of cesarean section has increased remarkably. Because of the widespread emphasis that is directed toward recognition of the impairment of fetal well-being as well as maternal complications. This study was carried out retrospectively based on the clinical charts of 2620 patients who had been performed cesarean section out of 10,943 deliveries from January 1, 1984 to December 31, 1988 at the department of Obstetrics and Gynecology, Wallace Memorial Baptist Hospital. The results were as follows: 1. Of the total deliveires, overall incidence of cesarean section was 23.9 %, fo which the incidence of primary cesarean section was 14.0 % and that of repeat cesarean section was 9.9 %. 2. The annual incidence had a tendency to gradual increment. 3. The indications for primary cesarean section were cephalopelvic disproportion (22.8 %), malpresentation (10.3 %), and fetal distress (8.1 %). 4. In the majority (93.4 %), general anesthesia was given, and in the remainder, spinal anesthesia was performed. 5. In the types of operation, lower segmental transverse incision was the most common (97.8 %), and classical section was 1.6 % in rate. 6. Approximately 66.7 % of all section was done in 21-31 year aged group. 7. Among the complication of cesarean section, wound infection (27.6 %) and puerperal infection (27.6 %) were the most prevalent. The others were urinary tract infection (13.8 %), postpartum bleeding (11.6 %), and fever of unknown origin (17.7 %). 8. In the combined operation, tubal sterilization was 17.3 %, and incidental appendectomy was 15.2 %. 9. Maternal morbidity rate was increased as the duration of rupture of membranes was extended. Particularly the group of more than 12 hours after rupture of membrances were higher greatly than the group of less than 12 hours. 10 It was found that maternal morbidity was 88 (per 1,000 cesarean section) and perinatal mortality was 22 (per 1,000 cesarean section).