瘢痕子宫再次剖宫产67例临床分析

Evaluation on repeat cesarean section of 67 cases

目的探讨前次剖宫产术后再次剖宫产的并发症及影响。方法回顾再次剖宫产术67例，对其年龄、孕周、两次剖官产术间隔时间以及前次剖官产的术式进行分析。结果再次剖宫产中，较严重的粘连8例，子宫切除1例。术中出血超过500ml者9例，占13．4％。腹壁横切口粘连发生率与腹壁纵切口下段剖宫产相比粘连发生率明显增高。结论在决定剖宫产术式时应综合考虑孕妇的产科情况选择腹壁切口及／子宫切口；前次手术的质量决定再次手术的并发症。

Objective To explore the complications and influence of repeat cesarean section after previous cesarean delivery. Methods The styles of the total 67 cases of repeat cesarean section were reviewed, and the maternal ages, gestational weeks, time intervals between the two times of delivery, and the styles of the previous cesarean section were analyzed Results Of the total 67 case of repeat cesarear section, there were 8 cases with relatively se- vere adhesion, 1 case with hysterectomy There were 9 cases with mtraoperatlve blood loss over 500ml（ 13.4% ）. The rate of adhesion induced by abdominal transverse incision of cesarean section was significantly higher than that of ab- / dominal longitudinal incision of low cesarean section ConcluSions When we determining a style of cesarean section, we should comprehensively consider the obstetrical eondittons of the pregnant women to select abdominal incision style and uterine incision style. The quality of previous cesarean delivery, determines the complications of repeat cesarean section.