疤痕子宫再次妊娠136例临床分析

A Clinical Analysis of 136 Cases of Pregnancies in a Uterine Scar

目的:提倡自然分娩,降低剖宫产及再次剖宫产率。方法:回顾性分析136例疤痕子宫再次妊娠(前次剖宫产133例)的患者资料。结果:136例中,阴道分娩9例,再次剖宫产127例,同时行绝育术33例。足月产128例,早产7例,过期产1例。前次剖宫产原因依次为:社会因素及原因不详,胎儿窘迫,前置胎盘和胎位异常,妊高征,巨大胎儿。术中发现较严重粘连者61例(48.03%)。产后出血8例(均合并前置胎盘、胎盘早剥、胎盘植入等严重并发症),子宫次全切除2例,其中1例并发膀胱破裂行修补术。结论:为降低剖宫产及再次剖宫产率,必须大力提倡自然分娩。

Objective： To encourage natural labour and reduce caesarean and repeated caesarean rates. Methods： A retrospective analysis of 136 cases of repeated pregnancies in a uterine scar at our hospital over a 7 - year period from January 1997 to December 2003. Results： Out of 136 cases of repeated pregnancies during the study period , there were 9 cases of vaginal delivery and 127 cases of repeatod caesarean section 33 among 136 cases were sterilization, which accounted for only 24. 26%. There were 128 cases of mature delivery , 7 cases of premature delivery and 1 case of postmature delivery. The sexy ratio of new - born baby boy and girl was 232 ： 100. There were 74 healthy alive babies （54. 41% ） , among which , 21 are boys and 53 are girls. The top six causes for previous caesareans are ： 39 cases of social factor and unknown reason, i6 cases of fetal distress, 15 cases of placenta previa, 15 cases of breech presentation , 12 cases of hypertensive states of pregnancy , and 10 cases of giant baby. There were 61 cases of serious placenta accreta （48. 03% ）, 8 cases of hemorrhage （all complicated with serious pregnant complications, example that placenta previable , premature separation of the placenta , placenta incretion , etc）, and 2 cases of uterectomy , one of which was complicated by tupture bladder and followed by a repairment. Condusion： Many factors accounting for rising caesarean and repeat caesarean birth rates are people＇s backward childbearing concept and low education , the fear of the pain of childbirth , and the overuse of caesarean section. As a result, it is necessary to encourage natural labour and reduce caesarean and repeat caesarean rates.