Clinical characteristics and influencing factors of acute colonic pseudo-obstruction after emergency cesarean section
Objective To explore the clinical characteristics and influencing factors of acute colonic pseudo-obstruction(ACPO)after emergency cesarean section.Methods A total of 22 parturients with ACPO after emergency cesarean section who were admitted to Hebei Children's Hospital from January 2019 to June 2023 were retrospectively selected and assigned to the ACPO group,and 110 parturients without ACPO after emergency cesarean section during the same period were selected as the non-ACPO group,according the ratio of 5∶1.The clinical characteristics of the ACPO group were observed.The clinical data of the two groups were collected and compared.Multivariate logistic regression methods were used to analyze the risk factors of ACPO after emergency cesarean section.Results All the patients with ACPO after emergency cesarean section presented with progressive abdominal dull pain,nausea and vomiting,abdominal distension,cessation of defecation and exhaust or a small amount of defecation and exhaust.Physical examination showed abdominal bulge,especially in the upper and right abdomen,with mild tenderness and with no rebounding pain.Univariate analysis showed that there were no significant differences in the maternal age,gestational weeks,embryo number,gravidity,parity,prenatal body mass index(BMI),cause of emergency cesarean section,pregnant complications,general anesthesia,preoperative albumin level or postoperative analgesia between the two groups(all P>0.05);the proportions of operation time≥60 min,blood loss≥800 ml,history of abdominal surgery,cocurrent chronic pelvic inflammatory disease,and intraoperative removal of uterine fibroids in the ACPO group were significantly higher than those in the non-ACPO group(all P<0.05).Multivariate logistic regression analysis showed that operation time≥60 min(OR=5.761),concurrent chronic pelvic inflammatory disease(OR=3.241),and intraoperative removal of uterine fibroids(OR=4.319)were the risk factors of ACPO after emergency cesarean section(all P<0.05).Conclusion Operation time≥60 min,concurrent chronic pelvic inflammatory disease,and intraoperative removal of uterine fibroids are the risk factors of ACPO after emergency cesarean section.More attention should be paid to the parturients with the above-mentioned risk factors after emergency cesarean section,and preventive measures should be taken in advance to effectively reduce the risk of postoperative ACPO.
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