剖宫产术后子宫瘢痕妊娠患者早期治疗后再妊娠临床结局观察

Clinical outcome of pregnancy after cesarean section in patients with cesarean scar pregnancy after early treatment

目的观察剖宫产术后子宫切口瘢痕妊娠(CSP)患者早期治疗后再妊娠的临床结局。方法选取自2013年1月至2016年12月收治的CSP早期治疗后再妊娠的89例患者纳入B组。选择同期剖宫产术后非CSP再妊娠的92例孕产妇纳入A组。比较两组孕产妇临床结局。结果 B组异位妊娠率为8.99%(8/89),A组异位妊娠率为5.43%(5/92),两组比较,差异无统计学意义(P>0.05)。B组流产率、早产率分别为20.22%(18/89)、14.61%(13/89),明显高于A组的9.78%(9/92)、6.52%(6/92),差异有统计学意义(P<0.05)。B组不良妊娠发生率为17.98%(16/89),明显高于A组的7.61%(7/92),两组比较,差异有统计学意义(P<0.05)。结论 CSP患者早期治疗后再次妊娠总体妊娠结局良好,但分娩风险及不良妊娠发生率均高于非CSP的剖宫产者。

Objective To observe the clinical outcome of re-pregnancy after cesarean section in patients with cesarean scar pregnancy after early treatment.Methods A total of 89 patients admitted to CSP from January 2013 to December 2016 who were re-pregnant after early treatment were divided into the Group B.92 cases of non-CSP re-pregnancy after cesarean section in the same period were divided into the Group A.The clinical outcomes of the two groups were compared.Results The ectopic pregnancy rate in Group B was 8.99%(8/89),while that in Group A was 5.43%(5/92).There was no significant difference between the two groups(P>0.05).The abortion rate and preterm birth rate in Group B were 20.22%(18/89)and 14.61%(13/89),respectively,which were significantly higher than those in Group A[9.78%(9/92)and 6.52%(6/92)],with statistically significant differences(P<0.05).The incidence of adverse pregnancy in Group B was 17.98%(16/89),significantly higher than that in Group A(7.61%,7/92),P<0.05.Conclusion The re-pregnancy of CSP patients after early treatment has a good overall pregnancy outcome,but the risk of childbirth and the incidence of adverse pregnancy were higher than that of non-CSP cesarean section.