剖宫产术中即刻放置吉娜宫内节育器的预后及安全性分析

目的探讨剖宫产术即刻放置吉娜宫内节育器(吉娜IUD)对产妇产后的影响及安全性。方法选择2016月5月至2018年6月制宫产妇女300例,其中150例不放置节育器为对照组,150例放置吉娜IUD为观察组。观察两组产妇短期预后,在产后42d、3个月、6个月、1年评估产妇月经异常、腹痛,应用B超动态监测宫内节育器位置,检测子宫内膜厚度、子宫动脉血流(阻力指数RI)、收缩/舒张比值(S/D)评估子宫内膜容受性,检测血清卵泡刺激素(FSH)、雌二醇(E2)、黄体生成素(LH)水平。结果两组产妇24h阴道出血量、恶露时间、恶露量、月经量比较,差异均无统计学意义(P>0.05),两组产妇术后42d、3个月、6个月、1年月经异常、腹痛及子宫内膜厚度、RI比较,差异均无统计学意义(P>0.05),两组产妇术后42d、3个月、6个月FSH、E2、LH比较,差异均无统计学意义(P>0.05);观察组产妇放置吉娜IUD无脱落病例,置环1年,1例环位置异常,1例因症取出,6例因有生育要求取出。结论剖宫产术中,给产妇即刻放置吉娜IUD,对产妇产后无明显影响,具有较高的安全性。

Objective To investigate the effect and safety of immediate placement of Gina intrauterine device(IUD)in cesarean section.Methods 300 women underwent cesarean section in hospital from May in 2016 to June in 2018 were selected,of which 150 were without placed contraceptive device as the control group and 150 were placed Gina(IUD)as the study group.The short-term prognosis of the two groups of women was observed,the abnormal menstrual period,abdominal pain were evaluated after birth 42 days,March.lune,and I vear.And the B-ultrasound was used to monitor the position of the IUD to detect the endometrial thickness and uterine artery blood tlow(resistance Index RI)and systolic/diastolic ratio(S/D)to assess endometrial receptivity and the serum follicle stimulating hormone(FSH),estradiol(E2),and luteining hormone(LH)were detected.Results The results of 24h vaginal bleeding,lochia time,lochia amount,and menstrual flow were compared between two groups,there was no significant difference(P>0.05).The postmenopausal menstrual abnormalities,abdominal pain and Endometrial thickness,RI after sureery 42 days.3 months,6 months,and I year compared between two groups,there was no sigmificant difference(P>0.05)Comparison of FSH.E2 and LH results at 42 days,3 months,and 6 month.e n,the differences were not statistically significant(P>0.05).Gynecological IUDs were placed in the study group,and there were no shedding cases of Gina IUDs.The ring was placed for I year.I ring was abnormal.I case was removed due to symptoms,6 cases were taken out for fertility requirements.Conclusion In cesarean section,the immediate placement of Gina IUD has no significant impact on the mother's postpartum and has high safety.