Разрез промежности-кто виноват?

[kuku]

Если вас действительно интересует статистика - есть pubmed и т.д. - если потратить не 10 минут, как я, а больше - вы найдете много подробных исследований. И другие факторы, к сожалению, тоже. Вот, например: Risk of autism was associated with smoking in early pregnancy, maternal birth outside Europe or North America, Caesarian delivery... Women... may be more prone to bleeding, and even to infertility. И т.д..


Почему, кстати, только с патологическими родами? Вы же говорите о преимуществах кесаревых без показаний перед любыми родами... О преимуществах при наличии серьезных показаний (более низком риске последствий кесарева) никто тут не спорил.

[Tundr]

Ну, это прям Щучкин портрет :-) :-) :-)

[Tundr]

Особенно в части полезности социуму :-)

При том что любые роды могут стать патологическими в процессе этих самых родов. И я не говорю о преимуществах. Я говорю о том, что каждый выбирает то что ему нравится. Говорю о том, что переубеждать человека решившего делать кесарево бесполезно. И он по своему прав.Если женщина хочет иметь шов на животе, а не в промежности - это ее право. И даже если она хочет швом на животе застраховаться от швов в промежности (ведь можно родить и без них) - это тоже ее право. Незачем осуждать.
Равно как и про растянутые вагины. Не факт, что у всех встает на место. У кого то все возвращается в форму у кого-то нет. И лично я не знаю от чего это зависит - от желания женщины заниматься собой, от физиологических ли факторов, но утверждать с пеной у рта, что после естеств. родов у ВСЕХ все возвращается на место глупо.

Я говорю о том, что надо с уважением относится к выбору других, чем бы он ни был обусловлен. А не кидаться на человека, доказывая свою правоту и собственные превосходства.

еще один из нескольких факторов риска для ребена - fetal laceration, порядка 2% - т.е. когда ребенка может порезать скальпель.

Кесарево при серьезном показании или экстренное оправдано факторами риска - т.е. в этих случаях риск его НЕ делать больше чем та совокупность факторов, которую оно с собой несет.

Отдельно <b> о факторах риска и негативных сторонах кесарева <u>(не для того чтобы смутить и закомплексовать тех кто его сделал вынужденно, а исключительно в познавательных целях для тех кто не знает) </u></b>.

Для начала вот как красиво и эстетично это выглядит:
<a href="http://pregnancy.about.com/library/blstaples.htm" target=new>шов после кесарева</a>

Кроме того что риск смерти (матери) от кесарева примерно в 4 раза выше, вот еще несколько факторов риска:


"Cesarean birth is major surgery, and, as with other surgical procedures, risks are involved. The estimated risk of a woman dying after a cesarean birth is less than one in 2,500 (the risk of death after a vaginal birth is less than one in 10,000). These are estimated risks for a large population of women. Individual medical conditions such as some heart problems may make the risk of vaginal birth higher than cesarean birth.

Other risks for the mother include the following:



<li>Infection. The uterus or nearby pelvic organs such as the bladder or kidneys can become infected. </li>
<li>Increased blood loss. Blood loss on the average is about twice as much with cesarean birth as with vaginal birth. However, blood transfusions are rarely needed during a cesarean. </li>
<li>Decreased bowel function. The bowel sometimes slows down for several days after surgery, resulting in distention, bloating and discomfort. </li>
<li>Respiratory complications. General anesthesia can sometimes lead to pneumonia. </li>
<li>Longer hospital stay and recovery time. Three to five days in the hospital is the common length of stay, whereas it is less than one to three days for a vaginal birth. </li>
<li>Reactions to anesthesia. The mother's health could be endangered by unexpected responses (such as blood pressure that drops quickly) to anesthesia or other medications during the surgery. </li>
<li>Risk of additional surgeries. For example, hysterectomy, bladder repair, etc.</li>

In cesarean birth, the possible risks to the baby include the following:


<li>Premature birth. If the due date was not accurately calculated, the baby could be delivered too early. </li>
<li>Breathing problems. Babies born by cesarean are more likely to develop breathing problems such as transient tachypnea (abnormally fast breathing during the first few days after birth). </li>
<li>Low Apgar scores. Babies born by cesarean sometimes have low Apgar scores. The low score can be an effect of the anesthesia and cesarean birth, or the baby may have been in distress to begin with. Or perhaps the baby was not stimulated as he or she would have been by vaginal birth. </li>
<li>Fetal injury. Although rare, the surgeon can accidentally nick the baby while making the uterine incision.</li>"

ссылка из http://www.childbirth.org/section/risks.html

продолжение следует ...

From a lecture by Marsden Wagner M.D. in New York City, April 2001 (http://www.midwiferytoday.com/enews/enews0325.asp?q=drugs)

"Women will only agree to cesarean section (CS) if they are convinced it is safe for them and their baby. One of the first efforts of obstetricians promoting CS has been to take the scientific evidence on risks of CS and torture the data until it confesses to what they want it to say. One example: Obstetric hype in popular and professional magazines says research shows 60% of women who have vaginal birth have urinary and fecal incontinence. But a careful reading of the research papers they refer to reveals something very different. The hype lumps all women with vaginal birth together instead of doing what the researchers did---dividing them into risk groups. When analysis of risk was done, they found that women at high risk for urinary and fecal incontinence have had large numbers of births; have had babies weighing over ten pounds at birth; and most importantly, have been the victims of unnecessary, aggressive obstetric interventions during their labor and birth.

What are these aggressive, invasive obstetric interventions that have been proven scientifically to cause permanent damage to the pelvic floor and urinary tract and also lead to more otherwise unnecessary CS? One example is the use of powerful and dangerous drugs to start or accelerate labor, a practice that has doubled during the past 10 years. These drugs make labor abnormal with violent contractions that can damage the uterus and pelvic floor. The only reason women agree to such induction is because they are not told the truth about the drugs, for example that Pitocin (oxytocin), a drug used for decades to induce labor, doubles the chance the woman will have urinary incontinence in the future. By withholding such facts doctors seduce to induce.

Induction with drugs is not the only aggressive, invasive intervention that is frequently used in vaginal birth and is associated with damage to the urinary system, pelvic floor and rectal areas. <b>Episiotomy has been scientifically shown to result in more pelvic floor damage than a natural tear. </b> When an effort was made in the 1980s to reduce CS in the United States, the rate of using forceps or vacuum extractor to pull the baby out went up--some doctors just can't stop doing invasive interventions. And there is good data that using forceps or vacuum to pull the baby out has more risk of pelvic floor damage than any other form of birth.

Obstetricians have turned birth into a surgical procedure and done damage to women's bodies and now suggest the solution is to promote yet even more radical and aggressive surgery, CS. The solution is less unnecessary invasive surgical procedures during birth, not more."

[Re: the E-News article, Issue 3:23]:<b> The two obstetricians tried to say that vaginal birth can damage a woman, but they never pointed out the ways in which CS can do harm not only to the woman but to the baby as well.</b> The following excerpt from my article "Choosing Cesarean Section" in The Lancet of November 11, 2000 reviews some of the dangers associated with CS, the alternative to vaginal birth that some doctors are trying to promote:

<b>"In addition to the increased risk the woman will die with an elective CS, there are other risks for the woman including <i>the usual morbidity associated with any major abdominal surgical procedure--anesthesia accidents, damage to blood vessels, accidental extension of the uterine incision, damage to the urinary bladder and other abdominal organs.</i></b> (1) Some of these risks are common: 20% of women develop fever after CS, most due to iatrogenic infections requiring diagnostic fever evaluation for both woman and baby. (1)

<b><i>There are also risks women carry to subsequent pregnancies due to scarring of the uterus including decreased fertility, increased miscarriage, increased ectopic pregnancy, increased placenta abruptio, increased placenta previa (1,2,3). </i></b>Recently in the United States the widespread use of the unapproved drug misoprostol (Cytotec) for labor induction has created a new risk of CS in subsequent pregnancies. Women attempting VBAC who are given misoprostol have a rate of uterine rupture of 5.6% compared with a rupture rate of 0.2% for women attempting VBAC not given misoprostol, a 28-fold increase in risk of uterine rupture. (4) For women choosing CS, all of these risks exist in all of their subsequent pregnancies even if the original CS was not an emergency. The increased risks of ectopic pregnancy, abruptio placenta, placenta previa and ruptured uterus are all life-threatening to both woman and baby.

<b>For whatever reasons women choose CS, very few are clearly informed about fetal risks. <i>In an emergency CS where the baby has developed a problem during the labor, the risks to the baby of doing the CS will likely be outweighed by the risks to the baby of not doing it. </i> In an elective CS where the baby is not in trouble, the risks to the baby from doing a CS still exist, meaning the woman who chooses CS puts her baby in unnecessary danger. </b> That some women are choosing CS strongly suggests women are not told this scientific facts.

The first danger to the baby during CS is the 1.9% chance the surgeon's knife will accidentally lacerate the fetus (6.0% when there is a non-vertex fetal position). (5) Obstetricians may be less aware of this risk--in one study only one of the 17 documented fetal lacerations was recorded by the obstetrician doing the surgery. (5)

A much more serious risk to babies born by CS is respiratory distress. Many reports in the scientific literature document the CS procedure per se is a potent risk factor for respiratory distress syndrome (RDS) in preterm infants and for other forms of respiratory distress in mature infants. (1) RDS is a major cause of neonatal mortality. The risk of newborn RDS is greatly reduced if the woman is allowed to go into labor prior to the CS.

Another serious risk to the baby born by CS is iatrogenic prematurity (the baby is premature because the CS was performed too early). Even with repeated ultrasound scans, the standard deviation for estimating gestational age is large, creating errors in judging when to do an elective CS. Doing the elective CS after the woman goes into spontaneous labor would markedly reduce this risk as well. A vast literature documents the increased mortality and morbidity, including neurological disability, associated with premature birth."

1. Wagner M, 1994. Pursuing the Birth Machine: The Search for Appropriate Birth Technology, Sydney, Australia: ACE Graphics.
2. Enkin M, Keirse M, Renfrew M, Neilson J, 1995. A Guide to Effective Care in Pregnancy and Childbirth , 2nd ed, Oxford University Press.
3.Goer, H, 1999. The Thinking Woman's Guide to a Better Birth. Putnam, New York: Penguin.
4.Plaut M, Schwartz M, Lubarsky S, 1999. "Uterine rupture associated with the use of misoprostol in the gravid patient with a previous cesarean section," Am J Obstet Gyn 180:1535-42.
5. Smith J, Hernandez C, Wax J, 1997. "Fetal laceration injury at cesarean delivery," Obstet & Gynecol 90:344-6.

So beware. Surgeons try to sell surgery. Never forget that obstetricians are, after all, surgeons. Women must be extremely cautious in the face of this hard sell and get the facts from those who do not have a vested interest in surgery.
- Marsden Wagner, M.D., M.S.P.H.

Оля, смотри один из факторов риска - Respiratory complications. General anesthesia can sometimes lead to pneumonia.


Т.е. бронхит твой похоже был из за анастезии, судя по вышесказаному это одно из общих осложнений.

[kuku]

Ну, если речь идет о 6-кратно более высокой смертности, то погрешность, сами понимаете, не сведет эту цифру к 1. Вы назвали бредом утверждения о возможных опасностях кесарева... И речь шла именно о статистике. Теперь уже не о ней?


В отличии от вас, у меня нету никакого мнения о преимуществах и однозначной положительности в целом какого-то метода для всех подряд. Есть идеальный с точки зрения медицины способ родоразрешения для идеальном модели женщины: обычные вагинальные роды без осложнений и вмешательств при позитивном настрое матери. И есть способы, подходящие каждой конкретной женщине с учетом ее особенностей (панически боящимся родов, кому не помогает помощь психолога, может быть оптимально именно кесарево). Но, выбрав для себя тот или иной способ, на мой взгляд, глупо закрывать глаза на его недостатки. Я отчетливо представляла себе риск эпидуралов, которые применяла - и представляю и сейчас, хотя лично я не столкнулась ни с какими последствиями во второй раз. И мне кажется, не избеги я в последний час кесарева, мне бы хватило здравого смысла, не утверждать, что это есть прекрасный и всем рекомендуемый способ, даже, если лично меня шов на животе жутко украсил.. И вот подобные рекомендации или отрицание очевидной информации, я, уж извините, действительно считаю проявлением глупости.



Что до проблемности британской медицины... Смертность рожениц в Москве (не по россии - там цифры куда хуже) 43,5 на 100 тыс., детей - 16.4 на 1000. В Англии это 10 и 6.

в собственной правоте