瘢痕子宫再次剖宫产与非瘢痕子宫剖宫产的妊娠结局分析

Comparative analysis of cesarean section in patients with scar uterus re-pregnancy and non-scarred uterus

目的分析并探讨瘢痕子宫再次剖宫产与非瘢痕子宫剖宫产妊娠结局的差异。方法 2014年1月至2016年1月莱芜市人民医院产科收治的瘢痕子宫再次剖宫产产妇100名作为观察组,选取同期收治的非瘢痕子宫剖宫产产妇100名作为对照组。观察并对比两组产妇妊娠结局,包括子宫破裂情况,胎盘情况以及手术情况。结果观察组先兆子宫破裂发生率为17.00%,不完全子宫破裂11.00%,完全子宫破裂1.00%。对照组先兆子宫破裂发生率为2.00%,不完全子宫破裂1.00%,无完全子宫破裂。观察组先兆子宫破裂和不完全子宫破裂发生率明显高于对照组(P<0.05)。观察组胎盘植入发生率为13.00%,前置胎盘发生率为12.00%,胎盘粘连发生率为12.00%。对照组胎盘植入发生率为2.00%,前置胎盘发生率为1.00%,胎盘粘连发生率为1.00%。观察组胎盘植入、前置胎盘以及胎盘粘连发生率明显高于对照组(P<0.05)。观察组手术时间、术中出血量明显高于对照组(P<0.05)。结论瘢痕子宫再次剖宫产与非瘢痕子宫剖宫产相比,危险性高,并发症发生率高,初产妇应慎重选择分娩方式。

Objective To analyze and compare the pregnancy outcome between secondary cesarean section in patients with scar uterus and non - scarred uterus cesarean section. Methods Selected 100 second cesarean section patients with sear uterus from January 2014 to January 2016 in Obstetrics Department of Laiwu City People＇s Hospital as the observation group. 100 non - scarred uterus cesarean section patients were seleoted as the control group. Observe and compare the two groups of maternal pregnancy outcome, including uterine rupture, placental conditions and surgery. Re.suits The incidence of uterine rupture was 17.00%, incomplete uterine rupture was 11.00% and complete uterine rupture was 1.00% in the observation group. The incidence of premenstrual uterine rupture was 2. 00%, incomplete uterine rupture was 1.00% and no complete uterine rupture was in the control group. The incidence of uterine rupture and incomplete uterine rupture in the observation group was significantly higher than that in the control group （P 〈0. 05）. The incidence of placenta accrete, placenta previa and placental adhesions was 13.00%, 12.00% and 12. 00% in the observation group. The incidence of placenta accrete, placenta previa and placental adhesions was 2.00%, 1.00% and 1.00% in the control group. The incidence of placenta accreta, placenta previa and placenta adhesion in the observation group was significantly higher than that in the control group （P 〈 0. 05）. The operation time and bleeding volume in the observation group were significantly higher than those in the control group （P 〈 0. 05）. Condtmion Secondary uterine cesarean section of scar uterus is more dangerous and has a higher complication rate than cesarean section of non - scar uterus. The mode of delivery should be chosen carefully in clinical practice.