瘢痕子宫对再次妊娠分娩方式和结局的影响

Abstract
Figure/Table
References
Related Citation (15)

Download: PDF (528 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To study the influence of the uterine scar pregnancy on the ways of delivery and outcome. Methods A retrospective survey was conducted of the patients who had been admitted to the obestetrics department of this hospital, all of whom had been under rules of regular inspection and had given birth to baby in the same hospital. The total sample included 322 cases of uterine scar pregnancy as the observation group, and 328 patients without uterine scar pregnancy as the control group by random. Comparison was made between the two groups in the ways of delivery and outcome of pregnancy. Results The comparisons of average age, average week of delivery, mean gravidity, mean parity between the two groups did not show statistically significant differences. 261 cases (81.1%) underwent cesaran section in the observation group, 173 cases (52.7%) did so in the control group, with statistically significant difference between the two groups. The incidence rates of placenta praevia and adherent placenta/implantation in the observation group were 13.7% and 9.0%, whereas those the incidences in the control group were 0.9% and 0.6%, the differences were statistically significant (χ²= 39.38, 25.22, P＜0.01). The incidence of hysterorrhexis and postpartum hemorrhage in the observation group was 1.6% and 10.9%, while those incidences in the control group was 0% and 2.7% in control group, the differences was statistically significant (χ²=5.13 and χ²=17.00, P＜0.05). The incidence of puerperal fever in the observation group was 11.5% and that incidence in the control group was 5.5%, the difference was statistically significant (χ²=7.56, P＜0.01). Conclusions The incidences of hysterorrhexis, postpartum hemorrhage, placenta praevia and adherent placenta/implantation in scarred uterus pregnancy is higher than those in the non-scarred uterus pregnancy. We advocate uterine still cesarean section deliveries for scar pregnant patients.

Key words： uterine scar pregnancy the previous history of cesarean section following pregnancy factors outcome

Received: 20 September 2014

ZTFLH:

R714

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	WANG Xin
	FANG Jie
	and SHANG Lixin

Cite this article:

WANG Xin,FANG Jie,and SHANG Lixin. Influence of uterine scar pregnancy on ways of delivery and outcome[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2014, 25(12): 1239-1241.

URL:

http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2014/V25/I12/1239

[9]	蒋学风, 罗新. 剖宫产术后再妊娠前置胎盘的风险[J]. 实用妇产科杂志, 2009, 25(10): 586-587.
[1]	丰有吉,沈铿. 妇产科学[M]. 2版. 北京:人民卫生出版社, 2010:207-212.
[10]	Rosen T. Placenta accreta and cesarean scar pregnancy: overlooked costs of the rising cesarean section rate[J]. Clin Perinatol, 2008, 35: 519-529.
[2]	廖予妹,耿正惠. 中国剖宫产现状及其远期影响[J]. 中国实用妇科与产科杂志, 2010, 26(8):630-632.
[3]	杨洪波,李晶, 陈杜平, 等. 剖宫产后再次妊娠的分娩方式探讨[J]. 实用妇产科杂志, 2004, 20(5): 273-274.
[11]	周晓莉, 郭秋琼, 肖晓菲, 等. 前置胎盘的发病因素及其对妊娠结局的影响[J]. 中国妇幼保健, 2010, 25(12) : 1616-1617.
[4]	Rozenberg P, Goffinet F, Phillippe H J, et al. Ultrasonographic measurement of lower uterine segment to assess risk of defects of scarred uterus[J]. Lancet, 1996, 347( 8997) : 281-284.
[12]	Chattopadhyay S K, Kharif H, Sherbeeni M M. Placenta praevia and accrete after previous caesarean section[J]. Eur J Obstet Gynecol Reprod Biol, 1993,52(3):151-156.
[5]	Martel M J, Mackinnon C J. Guidelines for vaginal birth after previous cesarean birth [J]. J Obstet Gynaecol Can, 2005, 27: 164-188.
[6]	Chapman K, Meire H, Chapman R. The value of serial ultrasounds in the management of recurrent uterine scar rupture[J]. Br J Obstet Gynaecol, 1994, 101(6): 549-551.
[13]	Seow K M, Cheng W C, Chuang J, et al. Methotrexate for cesareanscar pregnancy after in vitro fertilization and embryotransfer [J]. J Reprod Med, 2000,45(9):754-757.
[7]	申恒春. 剖宫产术后瘢痕子宫再次妊娠93例分娩方式探讨[J]. 实用妇产科杂志, 2013, 29(3): 234-236.
[14]	Fylstra D L. Ectopic pregnancy within a cesarean scar: a review [J]. Obstet Gynecol Surv, 2002,57(8):537-543.
[8]	Nguyen T V, Dinh T V, Suresh M S, et al. Vaginal birth after cesarean section at the University of Texas[J]. J Reprod Med, 1992, 37(10): 880-882.
[15]	吉鹏, 刘海港, 戴林, 等. 某三甲医院剖宫产率调查与分析[J]. 现代医院管理, 2014, 1(2): 56-58.
[9]	蒋学风, 罗新. 剖宫产术后再妊娠前置胎盘的风险[J]. 实用妇产科杂志, 2009, 25(10): 586-587.
[16]	曹善珠. 剖宫产术后产褥感染相关因素分析[J]. 中国妇幼保健, 2011, 26(6): 834-835.
[10]	Rosen T. Placenta accreta and cesarean scar pregnancy: overlooked costs of the rising cesarean section rate[J]. Clin Perinatol, 2008, 35: 519-529.
[11]	周晓莉, 郭秋琼, 肖晓菲, 等. 前置胎盘的发病因素及其对妊娠结局的影响[J]. 中国妇幼保健, 2010, 25(12) : 1616-1617.
[12]	Chattopadhyay S K, Kharif H, Sherbeeni M M. Placenta praevia and accrete after previous caesarean section[J]. Eur J Obstet Gynecol Reprod Biol, 1993,52(3):151-156.
[13]	Seow K M, Cheng W C, Chuang J, et al. Methotrexate for cesareanscar pregnancy after in vitro fertilization and embryotransfer [J]. J Reprod Med, 2000,45(9):754-757.
[14]	Fylstra D L. Ectopic pregnancy within a cesarean scar: a review [J]. Obstet Gynecol Surv, 2002,57(8):537-543.
[15]	吉鹏, 刘海港, 戴林, 等. 某三甲医院剖宫产率调查与分析[J]. 现代医院管理, 2014, 1(2): 56-58.
[16]	曹善珠. 剖宫产术后产褥感染相关因素分析[J]. 中国妇幼保健, 2011, 26(6): 834-835.