剖宫产再孕子宫瘢痕对妊娠的影响

Effect of cesarean uterine scar on pregnancy

目的探讨剖宫产再孕子宫瘢痕对于妊娠的影响。方法将本院232例瘢痕子宫再孕产妇归入瘢痕子宫组(SU组),并将其中符合阴道分娩试产指征的76例产妇归入瘢痕子宫阴道分娩组(SUV组),其他156例再次行剖宫产产妇归入瘢痕子宫剖宫产组(SUC组)。将本院同时期收治的232例子宫正常再孕产妇归入正常子宫组(NU组),其中76例行阴道分娩归入正常子宫阴道分娩组(NUV组),156例行剖宫产并归入正常子宫剖宫产组(NUC组)。对不同组别妊娠及分娩情况进行评价比较。结果 SU组盆腹腔粘连率、前置胎盘率显著高于NU组(P<0.05);SUV组产妇阴道分娩率显著低于NUV组(P<0.05),而新生儿窒息发生率显著高于NUV组(P<0.05);SUC组产后出血量、产后住院天数、产后发热率显著高于SUV组(P<0.05)。结论与正常子宫再孕相比,瘢痕子宫产妇妊娠风险增大,但严格执行试产指征采用阴道分娩能够缩短住院时间、降低产后发热率。

Objective To investigate the effect of cesarean uterine scar on pregnancy. Methods Firstly, 232 cases of uterine scar were classified into scar uterine group （ Group SU） , 76 of which complied with vaginal delivery indications and were reclassified in- to scarred uterus vaginal delivery group （Group SUV） and 156 of which were classified scar uterine cesarean group （Group SUC）. Secondly, another 232 cases with normal uterus were classified into normal uterus group （Group NU） , 76 of which went through va- ginal delivery and were classified into normal uterine vaginal delivery group （ Group NUV） , and 156 of which went through cesarean section and were classified into normal uterine cesarean group （ Group NUC）. Comparison of pregnancy and childbirth were comple- ted among the different groups. Results The rates of abdominal adhesion and placenta previa of Group SU were significantly higher than that of Group NU （ P 〈 O. 05 ） ; rate of vaginal delivery was significantly lower and that of neonatal asphyxia was significantly higher in Group SUV than in Group NUV （P 〈 0.05 ） ; the rates of postpartum hemorrhage, postpartum hospital stay, postpartum fever of Group SUC were significantly higher than that of Group SUV （ P 〈 0.05 ）. Conclusion Compared with normal uterus preg- nancy, uterine scar increases the risk of pregnancy and childbirth. Vaginal delivery in those who comply with vaginal delivery indi- cations helps to shorten hospital stay and lower postpartum fever rate.