瘢痕子宫患者再次妊娠剖宫产产后出血的相关因素分析

Analysis of patients with scar uterus cesarean section again pregnancy postoperative bleeding related factors

目的探讨瘢痕子宫患者再次妊娠剖宫产产后出血相关因素及预防措施。方法选取本院2010年1月～2012年1月收治的剖宫产产妇200例，将100例瘢痕子宫患者再次妊娠（剖宫产）产妇作为观察组，将100例首次剖宫产产妇作为对照组。对观察组产妇剖宫产产后出血因素进行分析，并比较两组产妇产后出血及并发症发生率。结果观察组剖宫产产后出血发生率为16．00（16／100），高于对照组（P〈0.05）；观察组术后并发症发生率高于对照组（P〈0.05）；25例胎盘粘连产妇巾，8例产妇出现产后出血，占32．00％；4例胎盘植入产妇巾3例产妇出现产后出血，占75．00％：9例前置胎盘产妇中5例出现产后出血，占55．56％；5例子宫破裂全部出现产后山血。结论瘢痕子宫患者再次妊娠增加了剖宫产产后并发症发生率，胎盘粘连、胎盘植入、前置胎盘、子宫破裂是剖宫产产后出血的相关危险因素。

Objective To discuss the patients with scar uterus pregnancy again factors associated with cesarean section postoperative bleeding and prevention measures. Methods Selection in our hospital from January 2010 to January 2012, 200 cases of cesarean section maternal, 100 patients with uterine scar pregnancy again as observation group, 100 cases of cesarean delivery for the first time women as control group.Analysis on the factors of maternal postoperative bleeding in observation group, and the incidence were compared between the two groups of postoperative hemorrhage and complications. Results The incidence of postoperative bleeding of the observation group was 16 （16/100）, higher than that of the control group （P〈0.05） ;among the 25 cases of placenta accreta maternal, bleeding in 8 cases of parturient after operation, accounting for 32% ;4 cases of placenta increta maternal,bleeding in 3 cases of parturient after operation, accounting for 75.00% ; among 9 cases of placenta previa maternal, there were 5 cases of postoperative hemorrhage, accounting for 55.56% ;5 cases of uterine rupture all postoperative bleeding. Conclusion Uterine scar pregnancy again increased the incidence of postoperative complications,placenta adhesion even,placenta,placenta previa, uterine rupture was related risk factors of postoperative hemorrhage.