Carski rez i rizici za novorođenče

master's thesis

• Title (english): Cesarean section and risks for newborn
• Author: Petra Gojković
• Mentor: Boris Filipović-Grčić (mentor)
• Committee member: Mirta Starčević (predsjednik povjerenstva)
• Committee member: Marija Jelušić (član povjerenstva)
• Committee member: Boris Filipović-Grčić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Pediatrics); Zagreb
• Defense date and country: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pediatrics

Abstract

Carski rez ( je kirurkirurški zahvat ekstrakcije fetusa kroz trbutrbušnu stijenku majke izvođenjem laparotomije i histerotomije. Premda je smrtnost majki i novorođenčadi kod carskog reza niska, ona je ipak nekoliko puta veća od stope pri vaginalnom porođaju Stopa učestalosti carskih rezova svakim danom ra ste sve više bez jasnih medicinskih indikacija. Prema preporukama Svjetske zdravstvene organizacija ( učestalost carskih rezova bi trebala biti između 10 i 15%, a danas prelazi i 30%. Nažalost, povećanje stope carskih rezova ne dovodi do smanjenja maternalnog i neonatalnog mortaliteta. Danas vrijedi preporuka da se elektivni carski rez ne bi trebao raditi prije navršenog 39. tjedna trudnoće zbog rizika od respiratornih komplikacija u novorođenčeta.

Istraživanja pokazuju kako je carski rez izražaj maternalne autonomije te kako su žene koje se odluče za sekciju prije p orođaj a starije životne dobi i višeg akademskog statusa. Danas je najčešći razlog želje za rađanjem carskim rezom upravo strah od porođajnih bolova.

Posljedice carskog reza za majku su dobro razjašnjene i naširoko raspravljane u literaturi, dok su dugoročne neonatalne posljedice još uvijek predmet istraživanja i rasprava. Rezultati studija pokazuju kako djeca rođena carskim rezom češće razvijaju respiratorne i neurološke poremećaje (poremećaji iz spektra autizma, shizofrenija) te imunosno posredovane poremećaje (atopijski dermatitis, juvenilni artritis, celijakija, šećerna bolest tip 1 metabolički sindrom). Također, vrijedi primijetiti kako postoje razlike u učestalosti g ore navedenih bolesti u slučajevima kad je kirurški postupak bio izveden nakon što je porod već počeo.

Abstract (english)

Cesarean section ( is a surgical procedure in which a child is extracted through the abdominal wall after performing laparotomy and hysterotomy. Although the mortality of cesarean section is low, i t is still higher than performing a vaginal birth. Birth by cesarean section is rising rapidly every day without clear medical indications. According to the recommendations of the World Health Organization ( the rates of cesarean section should range between 10 and 15%, but today it exceeds over 30%. Unfortunately, many surgical deliveries did not translate into reduced maternal or neonatal mortality. Today's recommendations say that elective CS delivery should not be done before 39 gestational weeks because of the risk of respiratory problems in the baby.

Research shows that cesarean delivery is often considered an expression of maternal autonomy and that women who decided for a section before labor was older and had more university or postgraduate education. Today's leading reason for the caesarian section is the fear of labor pains.

The maternal sequelae of cesarean sections are well elucidated and widely discussed in the literature, while long term neonatal consequences remain the issue of research and scientific dispute. Studies show that children delivered by cesarean section more commonly developed respiratory and neurological disorders (autism spectrum disorders, schizophrenia) and immune related diseases (skin atopy, juvenile arthritis, coeliac disease, type 1 diabetes ( or obesity). It is worth noting differences between the conditions mentioned above in cases when the surgical procedure was performed after delivery has started.

• Keywords: atopija; carski rez; crijevna mikrobiota; neonatalni ishodi; neurološki poremećaji; respiratorni poremećaji
• Keywords (english): atopia; cesarean section; gut microbiome; neonatal outcomes; neurological disorders; respiratory di s orders
• Language: croatian
• URN:NBN: urn:nbn:hr:105:883263
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-10-24 10:32:32