不同时期剖宫产瘢痕子宫人工流产患者的情况分析

Analysis of the situation of induced abortion after cesarean section scar uterus in different periods

目的探讨近5年不同时期瘢痕子宫人工流产情况和影响因素。方法抽取近5年3个时期在陆军军医大学第一附属医院(重庆西南医院)门诊计划生育室所有剖宫产瘢痕子宫实施人工流产患者的临床资料,比较群体特征、再次妊娠不良结局情况(瘢痕妊娠和稽留流产),用SPSS软件对数据的统计意义进行检验。根据发生时期分组:2012年组(1 136例); 2014年组(1 111例); 2016年组(1 298例)。结果 2012年组:瘢痕妊娠(1. 6%)和稽留流产(5. 1%)的发病率低;2014年组:瘢痕子宫的人工流产患者中剖宫产1次(91. 2%)、人工流产≥3次(51. 3%)、瘢痕妊娠(9. 3%)和稽留流产(8. 6%)比例高于组1; 2016年组:瘢痕子宫的人工流产比例(46. 9%)高于2012年组和2014年组,剖宫产≥2次(14. 4%)、剖宫产2年以上(88. 6%)、≥40岁(11. 5%)、瘢痕妊娠(12. 6%)及稽留流产(14. 9%)发病率高于2012年组和2014年组,差异均有统计学意义(P <0. 05)。结论瘢痕子宫患者人工流产率明显增高,瘢痕妊娠及稽留流产所占比例明显增高,应及时调整门诊计划生育工作,落实高效避孕措施及降低人工流产并发症发生率。

Objective To explore the situation and influencing factors of artificial abortion of scar uterus in different periods in the past 5 years.Methods In the past 5 years and three periods,in the outpatient clinic of the First Affiliated Hospital of Army Medical University(Chongqing Southwest Hospital),all the cesarean section scar uterus were compared with the abortion,and the characteristics of the group and the adverse pregnancy outcome(scar pregnancy and missed abortion) were compared,using SPSS software to test the statistical significance of the data.The specific groupings of abortion women were as follows: Group 2012;Group2014;Group 2016.Results Group 2012: The incidence of scar pregnancy(1.6 %) and missed abortion(5.1 %) were low;Group2014: cesarean section 1(91.2 %) and induced abortion ≥3 times(51.3 %) in patients with abortion of scar uterus the proportion of scar pregnancy(9.3 %) and missed abortion(8.6 %) were higher those that of group 2012;Group 2016: the proportion of artificial abortion of scar uterus(46.9 %) was higher those that of group 2012 and group 2014,cesarean section ≥ 2 times(14.4 %) The incidence of cesarean section for more than 2 years(88.6 %),≥ 40 years(11.5 %),scar pregnancy(12.6 %) and missed abortion(14.9 %) were higher than that of group 2012 and group 2014,the differences were statistically significant(P<0.05).Conclusion The rate of artificial abortion in patients with scar uterus increased significantly,and the proportion of scar pregnancy and missed abortion increased significantly.The outpatient clinic should be adjusted in time to implement effective contraceptive measures and reduce the incidence of complications of induced abortion.