两次剖宫产后妊娠并发症高危因素分析

Analysis of the high risk factor of the twice cesarean section delivery＇s pregnancy neopathy

目的探讨两次剖宫产后再次妊娠及其并发症的危险因素，为避免第三次剖宫产提供临床依据。方法回顾性分析18例两次剖宫产后再次妊娠、分娩发生的并发症及结局。结果前置胎盘发生率22％（4／18），前置胎盘瘢痕植入1例，子宫瘢痕破裂5例，第三次剖宫产术中大出血占5％（9／18），手术损伤占17％（3／18）。子宫切除2例，切口感染4例，围生儿死亡率11％（2／18）。结论两次剖宫产后再次妊娠分娩风险高、并发症多而且严重。分娩方式选择妊娠37～38周剖宫产，不宜阴道分娩。

Objective To investigate the high risk factor of the twice cesarean section delivery＇s pregnancy neopathy, to offer clinical evidence for avoiding tertium cesarean section delivery. Methods 18 cesarean section delivery pregnancy childbirth of neopathy and treat end were retrospectively analyzed. Re.suits Placenta previa＇s incidence rate is 22 % （4/18）. Placenta previa of cicatricle implant is 6 % （1/18）. Utero-cicatricle to crack 28 % （5/18）. Tertium cesarean section delivery have hemorrhoea 5 % （9/18 ）. Operation damage 17 % （3/18 ）. Hysterectomia 11% （2/18）. Infection of incisional wound 22 % （4/18）. New birth death rate is 11% （2/18）. ConcluSion After twice cesarean section delivery pregnancy,deliver risk is high, neopathy more and serious. Delivery mode chosen for pregnancy 37-38 weeks vaginal delivery is not proper.