Der Gynäkologe

, Volume 46, Issue 10, pp 735–738 | Cite as

Kurz- und Langzeitfolgen der Sectio aus neonatologischer Sicht

Leitthema
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Zusammenfassung

Kaiserschnittentbindung ist potenziell lebensrettend für Kinder mit geburtsunmöglicher Lage, Schädel-Becken-Missverhältnis, gewissen fetalen Anomalien und mütterlichen Infektionen sowie für höhergradige Mehrlinge. Darüber hinaus dürften extrem unreife Frühgeborene an der Grenze der Überlebensfähigkeit von einer Sectio hinsichtlich einer signifikant geringeren Mortalität im Vergleich zu vaginaler Entbindung profitieren. Die Hauptrisiken für Neugeborene nach Sectio ergeben sich aus den Folgen einer iatrogenen Frühgeburt und der erhöhten respiratorischen Morbidität auch Reifgeborener. Eine elektive Kaiserschnittentbindung ohne medizinische Indikation hat aus neonatologischer Sicht deshalb nicht vor der Schwangerschaftswoche 39 + 0 zu erfolgen. Andere Risiken für das Neugeborene beinhalten eine verzögerte Etablierung des Stillens sowie ein möglicherweise erhöhtes Risiko für die Entwicklung allergischer Erkrankungen im Kindesalter, speziell Asthma bronchiale, allergische Rhinitis und Diabetes mellitus Typ I. Diese Langzeitauswirkungen sind auf Populationsniveau gering, die Frage des kausalen Zusammenhangs ungeklärt. Aus kinderärztlicher Sicht müssen Eltern speziell vor einer elektiven Kaiserschnittentbindung ohne medizinische Indikation über die Vor- und Nachteile der Sectio im Vergleich zu vaginaler Geburt inklusive möglicher Langzeitauswirkungen aufgeklärt werden.

Schlüsselwörter

Sectio Respiratorische Morbidität Neonatale Mortalität Langzeitauswirkungen Neugeborenes 

Short-term and long-term effects of cesarean delivery: focus on the neonate

Abstract

Cesarean sections are potentially life-saving for neonates with certain congenital anomalies and maternal infections, fetal malpresentation, cephalopelvic disproportion, multiple pregnancies and failure of labor progression. Additionally, there seems to be a significant survival advantage associated with cesarean delivery in extremely preterm infants of less than 25 weeks gestation. The main risk for neonates after cesarean section is the increased respiratory morbidity often requiring admission to an intensive care unit. Consequently, elective cesarean sections without medical indications should not be performed prior to 39 + 0 weeks of gestation. Other risks for the neonate include a delayed initiation of breastfeeding as well as a potentially increased risk for allergic conditions, such as asthma, allergic rhinitis and type 1 diabetes mellitus. The possible impact of increasing numbers of cesarean deliveries on the overall burden of allergic diseases is, however, small at the population level and causality has never been proven. However, it has to be assured that parents are counseled on the short-term and long-term consequences of a cesarean section particularly when performed electively at term on maternal request.

Keywords

Cesarean section Respiratory morbidity Infant mortality Long-term consequences Newborn 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Abt. für Neonatologie, Pädiatrische Intensivmedizin und NeuropädiatrieUniversitätsklinik für Kinder- und JugendheilkundeWienÖsterreich

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