38例疤痕子宫妊娠引产分析

Analysis of induced abortion in 38 cases of scarred uterus pregnancy

目的：探讨终止疤痕子宫（均为子宫下段剖宫产术后）中晚期妊娠的治疗方法。方法：对我院2003年1月～2006年12月年行疤痕子宫中晚期妊娠要求终止妊娠患者38例，分别采用剖宫取胎方法、利凡诺尔羊膜腔内注射法、米非司酮联合米索前列醇法和水囊引产法。选择同期非疤痕子宫引产者208例，将引产方法相同的疤痕子宫与非疤痕子宫进行比较，观察其一般情况、胎儿胎盘娩出时间、产时出血及软产道裂伤情况。结果：7例剖宫产术后半年内妊娠的疤痕子宫引产均采用剖宫取胎的方法。余31例剖宫产术后半年后妊娠的疤痕子宫引产分别采用其余3种方法。无1例子宫破裂发生；同种引产方法比较，疤痕子宫与正常子宫胎儿胎盘排出时间、产时出血及软产道裂伤较无差异显著性（P〉0．05）。结论：剖宫产术后半年后疤痕子宫中晚期妊娠引产可以在严密观察下施行常用几种引产方法。

Objective： To study the ways for pregnancy termination of second and third trimester in a scarred uterus. Methods： During 4 - year period from 2003. 1 - 2006. 12 of 246 women of 15 - 34 weeks of gestation who underwent termination of pregnancy were studied. Thirty -eight patients with a scarred uterus underwent at least previous one cesarean section were selected and 208 served as con- trols. Termination was undertaken by foUowing methods： caesarean section, rivanol intraamniotic, misoprostol and prostaglandin and water balloon. Results： 7 scarred uterus pregnancy within six months after the previous caesarean section were terminated by caesarean section; the other 31 scarred uterus pregnancy beyond six months after the previous caesarean section were terminated by the other three methods. The two groups using the same method were similar for maternal age and gestational age, the mean induction to abortion time and the complication rate were similar in both groups. No uterine rupture was observed. Conclusion： Under the strict observation, the common inducing abortion methods are safe procedure for a scarred uterus second and third trimester termination which beyond six months after the previous caesarean section.