初次剖宫产与瘢痕子宫再次剖宫产的临床研究

Clinical Study on First cesarean Section and second cesarean Section with Scar Uterus

目的探讨初次剖宫产与瘢痕子宫再次妊娠剖宫产的预后。方法回顾性分析江宁区中医医院2017年1月至2019年12月收治的120例剖宫产分娩孕产妇临床资料。根据孕妇是否为初次剖宫产分为观察组(58例)及对照组(62例),对照组为初次剖宫产,观察组为瘢痕子宫再次剖宫产,对比两组产妇的术中出血量、产后恶露持续时间、手术时间、产后出血量。对比两组产妇静止状态下子宫不完全破裂发生率、盆腔粘连发生率、胎盘粘连率、产后大出血发生率。结果观察组的术中出血量、产后恶露持续时间、手术时间、产后出血量明显较对照组高(P<0.05)。观察组静止状态下子宫不完全破裂发生率、盆腔粘连发生率、胎盘粘连率、产后大出血发生率较对照组高(P<0.05)。结论瘢痕子宫再次妊娠行剖宫产手术风险较初次剖宫产高,临床上需对无临床医学指征的剖宫产进行严格控制。

Objective To explore the prognosis of the first cesarean section and the second Cesarean section with scar uterus.Methods The clinical data of 120 cases of cesarean section delivery in Jiangning District Hospital of traditional Chinese medicine from January 2017 to December 2019 were analyzed retrospectively.The pregnant women were divided into observation group(58 cases)and control group(62 cases)according to whether they had the first cesarean section,the control group was the first cesarean section,the observation group was the scar uterus again cesarean section,the amount of intraoperative bleeding,the duration of Lochia,the time of operation and the amount of postpartum bleeding were compared between two groups.The incidence of incomplete uterine rupture,pelvic adhesions,placental adhesions and postpartum hemorrhage were compared between the two groups.Results The amount of intraoperative bleeding,postpartum lochia duration,operation time and postpartum bleeding in the observation group were significantly higher than those in the control group(P<0.05).The incidence of incomplete rupture of uterus,pelvic adhesion,placenta adhesion and postpartum hemorrhage in the observation group were higher than those in the control group(P<0.05).Conclusion The risk of cesarean section in second pregnancy of scar uterus is higher than that in first cesarean section,the cesarean section without clinical medical indication should be strictly controlled in clinic.