影响剖宫产瘢痕妊娠发生的危险因素分析

Analysis of risk factors influencing the occurrence of cesarean scar pregnancy

目的探讨影响剖宫产瘢痕妊娠(CSP)发生的相关危险因素,为该类妊娠期女性的临床诊疗积累循证经验。方法选择48例CSP患者为研究组,选取51例同期有剖宫产史但再次妊娠未出现瘢痕妊娠者作为对照组。通过单因素分析以及Logistic回归分析,明确CSP的相关危险因素。结果单因素分析显示,两组在流产次数、距末次剖宫/流产时间、学历、盆腹腔手术史、妊娠早期阴道流血方面差异均有统计学意义(P<0.05)。多因素分析显示,距末次剖宫/流产时间、妊娠早期阴道流血为CSP发病的独立危险因素。结论CSP发生的独立危险因素包括距末次剖宫/流产时间、早孕期阴道流血,临床医生应重视,并在早期实施相应干预。

Objective To explore the risk factors influencing the occurrence of cesarean scar pregnancy(CSP),in order to accumulate evidence-based experience for the clinical diagnosis and treatment of these pregnant women.Methods Forty-eight CSP patients were selected as the study group,and 51 cases with cesarean section history but no scar pregnancy throughout re-pregnancy period were selected as the control group.Univariate analysis and logistic regression analysis were performed to ascertain the risk factors for CSP.Results Univariate analysis revealed that there were statistically significant differences between the two groups in the number of abortion,the time from the last cesarean section/abortion time,educational background,the history of pelvic and abdominal surgery,and the vaginal bleeding in early pregnancy(P<0.05).Multivariate analysis exhibited that the time from the last cesarean section/abortion and vaginal bleeding in early pregnancy were independent risk factors for CSP.Conclusion The independent risk factors for CSP include the time from the last cesarean section/abortion,vaginal bleeding in early pregnancy.Clinicians should pay attention to them and implement corresponding interventions in the early stage.