瘢痕子宫妊娠经阴道处理22例报告

22 CASES OF MANAGEMENT OF PREGNANCY THROUGH VAGINA IN PATIENTS WITH SCAR UTERUS

在22例瘢痕子宫妊娠者中,剖宫产瘢痕20例,肌瘤核除及子宫穿孔各1例。瘢痕时间4个月到7年。妊娠少于和等于28周者12例(均行雷夫奴尔引产-流产,时间平均41°45’,胎盘残留需刮宫者6例),平均失血量为267ml。大于28周者10例,均经阴道分娩,其中4例阴道助产,总产程平均19°18’,胎盘均自然娩出,第三产程平均7′,产后出血50～350ml,平均190ml。新生儿体重1400～4 200g,2例早产儿分别为1 400g和2 250g,足月7例,体重3 165～3 780g,过期产1例,体重为4 200g,产钳助产。6例自然分娩新生儿中有3例不足3 750g。超过28周者无胎盘残留或植入,而小于28周者为50％。本组22例未发生子宫破裂,无孕妇及围产儿死亡发生。

In the 22 cases of the pregnancy in patents with scar uterus, 20 cases had given birth by caesarean section, one case is muscular tumour removed and one perforation in uterus.The scars lasted for 4 months^7 years.Among them 12 cases of pregnancy lasted less than or equaled 28' weeks (all abortion by using rivanol average time:41 45', in 6 cases the remains of placenta in uterus need curettage) , the average amount of blood loss is 267ml.10 casesof pregnanacy lasted more than 28 weeks, which give birth through vagina, among them 6 natural birth, 4 assissted birth through vagina, the whole birth procession in average time of the 10 cases. 19 18', the placentas all delivered naturally, the average time of the third birth procession 7', the amount of the blood loss after delivery is 50~350, the average. 190 ml.The new born infants weigh 1 400~4 200g, 2 cases of premature delivery, the infants weigh 1 400 and 2 250g,in 7 cases of mature, the infants weigh 3 165 ~3 780g, one case extended delivery, by obstetric forceps the infant weigh 4 200g.Among the 6 cases of natural delivery 3 cases of the new born infants less than 3 750.There are no remains of placentas in the groups of the pregnancy which lasted more than 28 weeks.In the group of the 22 cases there are no urerine rupture and no new born infants died.