Совсем недавно в Турции посчитали осложнения для матери и ребенка при 4-5 кесаревом в сравнении со 2-3-им и нашли повышенный риск послеоперационных осложнений и внутриутробной смерти плода - так что Вы должны быть предупреждены и самостоятельно решать перевязывать трубы или нет...
краткая квинтэссенция на английском для коллег:
A case control study was conducted in a single tertiary maternity and children's center. The outcome of a study group including 122 pregnant women undergoing cesarean section for the fourth or fifth time was compared with a control group comprising 146 women sectioned for the second and third time. All multiple repeated cesarean sections were divided into urgent and elective groups to compare the outcome measures of demographic, neonatal, intra- and post-operative data.
Compared with the control group, the study group had significantly lower birth weights (p=0.026), lower Apgar scores at 1 minute (p=0.0001) and 5 minutes (p=0.042), higher numbers of fetal death (p=0.03), higher rate of omentum adhesions (p =0.0001) and peritoneal adhesions (p=0.008), increased risk of cesarean hysterectomy (p = 0.014), increased need for transfusion (p = 0.018), and an increase in hospitalization days (p=0.005). Compared with the elective group, preterm birth incidence was higher (p = 0.01) and birth weight was lower (p=0.004) in the urgent group. The risk for myometrium herniation (p=0.018), need for drainage during operation (p=0.018), and post-operative fever (p =0.001) was also more common in the urgent group.
Patients must be informed about the related risks of multiple repeated cesarean sections and tubal ligation needs to be encouraged.
Taiwan J Obstet Gynecol. 2010 Dec;49(4):425-31.
Multiple repeated cesarean deliveries: operative complications in the fourth and fifth surgeries in urgent and elective cases.
Gedikbasi A, Akyol A, Bingol B, Cakmak D, Sargin A, Uncu R, Ceylan Y.
SourceDepartment of Obstetrics and Gynecology, Istanbul Bakirkoy Maternity and Children Diseases Hospital, Istanbul, Turkey
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