剖宫产瘢痕妊娠的发病危险因素分析

Analysis of risk factors of cesarean section scar pregnancy

目的探讨剖宫产术后瘢痕妊娠(CSP)潜在危险因素。方法选取2018年5月至2020年5月我院诊治的48例CSP患者为观察组,同期48例有剖宫产史的正常宫内妊娠者为对照组。进行单因素分析以及Logistic回归分析,寻找初次CSP发生的独立危险因素。结果两组在剖宫产瘢痕憩室,上次剖宫产缝合方法、距末次剖宫产时间、流产次数、早孕期腹痛及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,剖宫产瘢痕憩室、距末次剖宫产时间、腹痛及阴道出血是CSP发病的独立危险因素(P<0.05)。结论对于有剖宫产史的患者,一旦确认妊娠,了解其有无剖宫产瘢痕憩室、距上次妊娠时间、孕早期有无先兆流产症状,结合阴道超声,早期发现并早期治疗。

Objective To explore the potential risk factors of cesarean scar pregnancy(CSP).Methods From May 2018 to May 2020,48 CSP patients in our hospital were selected as an observation group,and 48 normal intrauterine pregnancies with ahistory of cesarean section were selected as a control group.Univariate analysis and logistic regression analysis were performed to find independent risk factors for the occurrence of the initial CSP.Results There were significant differences between the two groups in cesarean scar diverticulum,suture method of the last cesarean section,time tothe last cesarean section,numbers of abortion,abdominal pain at early pregnancy,and vaginal bleeding(P<0.05).Multi-factor analysis showed that the independent risk factorsfor CSP were cesarean scar diverticulum,time to the last cesarean section,abdominal pain,and vaginal bleeding(P<0.05).Conclusion For patients with a history of cesarean section,once pregnancy is confirmed,it should find out if there is the cesarean scar diverticulum,what time to the last pregnancy,and whether there are symptoms of threatened abortion at early pregnancy.It should also combine the transvaginal ultrasound results for early detection and treatment.