孕中晚期子宫破裂14例临床分析

Clinical analysis of 14 cases of uterine rupture during middle and late pregnancy

目的探讨妊娠期及分娩期子宫破裂的临床特点及危险因素。方法对2011年1月至2021年12月郑州大学第二附属医院收治的14例子宫破裂患者的临床资料进行回顾性分析。结果14例子宫破裂的患者中剖宫产术后瘢痕子宫11例,非瘢痕子宫3例;不完全性子宫破裂11例,完全性子宫破裂3例。3例完全性子宫破裂患者中2例行子宫切除术、围产儿死亡;1例行子宫修补术、新生儿重度窒息。无孕产妇死亡。结论瘢痕子宫是导致子宫破裂最重要的危险因素,应安全降低首次剖宫产率,同时加强高危孕产妇的管理及监护,提高子宫破裂的早期识别和应急处理的能力。

Objective To analyze the clinical characteristics and risk factors of the uterine rupture during pregnancy and delivery.Methods Data of 14 patients diagnosed with uterine rupture from January 2011 to December 2021 in the Second Affiliated Hospital of Zhengzhou University were analyzed retrospectively.Results Among the 14 patients,11 patients were multipara with uterine scar after the previous cesarean section and 3 patients had non-scar uterus;11 patients suffered with incomplete uterine rupture and 3 patients with complete uterine rupture.In the 3 patients with complete uterine rupture,2 patients were made hysterectomy and the perinatal infants died,the uterus of 1 patient were repaired and the newborn was severely asphyxiated.There was no maternal death.Conclusion Uterine scar has become the most important risk factor for uterine rupture,efforts should be made to control the rate of primary cesarean section;moreover,the obstetrician should keep an eye on the gravida with high risks of uterine rupture,intensify the supervision and the monitoring during pregnancy and childbirth,constantly improve the ability of early diagnosis and emergent treatment of uterine rupture.