妊娠期子宫破裂24例临床分析

Clinical analysis of 24 cases of uterine rupture during pregnancy

目的：探讨妊娠期子宫破裂的原因、临床特点及预防措施。方法对2004年1月至2014年1月收治的24例子宫破裂孕产妇的临床资料进行回顾性分析。结果24例子宫破裂患者中瘢痕子宫16例，非瘢痕子宫8例；中孕引产2例，晚期妊娠22例；完全子宫破裂4例，不全子宫破裂20例。22例行子宫修补术，2例行全子宫切除术；1例孕产妇死亡，其余产妇均抢救成功。子宫破裂的临床表现不一，其中14例不全子宫破裂为瘢痕子宫择期手术术中诊断。结论瘢痕子宫为妊娠期子宫破裂的主要原因，为降低子宫破裂发生率应降低剖宫产率，加强孕期管理和监护，提高诊治子宫破裂高危患者的能力。

Objective To investigate the cause, clinical characteristics and preventive measures of the uterine rupture during pregnancy.Methods The clinical data of 24 patients diagnosed with uter-ine rupture from January 2004 to January 2014 in the Third Affiliated Hospital of Zhengzhou University were retrospectively analyzed.Results Among the 24 patients, 16 patients were multipara with uterine scar after the previous cesarean section, 2 cases of mid pregnancy, 22 cases of third trimester, 4 cases of complete uterine rupture, 20 cases of incomplete uterine rupture, 2 cases were made hysterectomy, the rest of was made repair, only one maternal death, the clinical manifestations of uterine rupture varied in some degree, 14 patients had no obvious symptoms.Fourteen incomplete uterine rupture were diagnosed during operation.Conclusions Uterine scar has become the most common cause of uterine rupture, ef-forts should be made to control the rate of cesarea section in primiparas, during the whole pregnancy, the obstetrician should keep an eye on the gravida, intensify the supervision and the monitoring of the gesta-tion, constantly improve the ability of diagnosis and treatment of utetine rupture in high-risk patients.