剖宫产术后瘢痕处妊娠的高危因素探讨

Study on high risk factors of pregnancy at the scar after cesarean section

目的探讨剖宫产术后瘢痕处妊娠的高危因素,提高诊断水平。方法剖宫产手术史且合并瘢痕处妊娠的患者34例纳入瘢痕妊娠组,同期在我院接受剖宫产手术但未合并瘢痕处妊娠的产妇34例,纳入对照组。比较两组的手术指征、人工流产次数、手术医院级别等。结果两组的产程延长例次、胎儿宫内窘迫例次、产科合并症例次、剖宫产次数及反复宫腔操作例次比较,差异均有统计学意义。两组接受最近一次剖宫产手术的医院级别、人工流产平均次数比较,差异有统计学意义。Logistic回归分析结果显示,产程延长、胎儿窘迫、产科合并症、反复宫腔操作、剖宫产2次以上均是影响瘢痕处妊娠的高危因素。结论产程延长、胎儿窘迫、产科合并症、剖宫产次数、反复宫腔操作均是影响瘢痕处妊娠的高危因素。

Objective To explore the high risk factors of pregnancy at the scar after cesarean section ,and improve the diagnostic level. Methods A total of 34 patients of cesarean section operation with scar pregnancy were arranged in scar pregnancy group,in the same period,34 patients who received cesarean operation but not with scar pregnancy were arranged in the control group. Results The production process extension number,fetal distress number,obstetric com-plications number,fetal breech number,repeated uterine cavity operation number ,comparison difference had statistics significance. Recent cesarean operation of hospital level , the average number of artificial abortion of two groups had statistical significance differences. The results of logistic regression analysis display, prolonged labor, fetal distress, obstetric complications, recurrentuterine cavity operation, cesarean section 2 above are all risk factors influencing the scar pregnancy. Conclusion Prolonged labor, fetal distress, obstetric complications, breech presentation,recurrent u-terine cavity operation are risk factors of scar pregnancy.