妊娠中期瘢痕子宫破裂修补术后继续妊娠分娩的护理

Nursing of a patient with continued pregnancy delivery after repair of mid-trimester scar uterine rupture

总结1例妊娠中期瘢痕子宫破裂修补术后继续妊娠至34周分娩患者的护理体会。针对妊娠中期子宫破裂继续妊娠意愿强烈的患者,需完成高难度子宫瘢痕修补手术,术后继续妊娠可能并发再次子宫破裂、胎膜早破、静脉血栓形成及早产等问题,病情罕见、风险高;需早期识别子宫破裂症状,根据病情进展提供专业的心理疏导及特殊用药监测,同时多学科团队合作,做好手术配合及预控母儿并发症。经精心的治疗和护理,患者从孕24^(+2)周延长妊娠至34^(+3)周并成功分娩一男婴,母儿结局良好,剖宫产术后6d出院。

To summarize the nursing experience of a patient who continued pregnancy to 34 weeks after repair of mid-trimester scar uterine rupture.For a patient with a strong intention to continue pregnancy with uterine rupture in the second trimester of pregnancy,we need to complete difficult uterine scar repair surgery,and postoperative pregnancy may be complicated with uterine rupture,premature rupture of fetal membranes,venous thrombosis and premature birth.The case was rare and high risk.Nurses needed to identify early symptoms of uterine rupture,provide professional psychological counseling and special medication monitoring according to the progress of the condition.At the same time multidisciplinary collaboration was needed for surgical cooperation and control of maternal complications.After careful treatment and care,the patient extended her pregnancy from 24^(+2) weeks to 34^(+3)weeks and successfully delivered a male infant.The maternal and newborn outcome were good and they were discharged 6 d after caesarean section.