摘要
目的:研究腹壁瘢痕POSAS评估对再次剖宫产时产妇发生盆腔粘连情况的预测价值。方法:选取2018年1月至6月在佛山市妇幼保健院分娩的行第二次剖宫产术的疤痕子宫孕妇100例,进行腹壁瘢痕POSAS评估,根据评分结果,将POSAS≥56分的孕妇分为瘢痕严重组(研究组,50例),将POSAS<56分的孕妇分为瘢痕轻微组(对照组,50例),统计分析两组产妇的术中一般情况、术中盆腔粘连程度、分娩后的近期并发症发生情况、术后子宫切口瘢痕形成情况。结果:研究组产妇的手术时间、开腹至胎儿娩出时间均显著高于对照组,术中出血量显著多于对照组,术中盆腔粘连发生率显著高于对照组;其中轻度粘连比例显著低于对照组,中度粘连、重度粘连比例均显著高于对照组(均P<0.05)。两组产妇分娩后的近期产后出血、产褥感染、腹部切口感染、不完全性肠梗阻及膀胱或肠管损伤的发生率均没有显著差异(均P>0.05)。结论:腹壁瘢痕POSAS评估对再次剖宫产时产妇发生盆腔粘连情况的预测价值高。
Objective:To evaluate the value of patient and observer scar assessment scale(POSAS)in predicting pelvic adhesions for women undergoing repeat cesarean delivery.Methods:A total of 100 pregnant women with scarred uterus schedued for repeat cesarean delivery at Foshan Maternal and Children’s Hospital between January and June 2018 were enrolled and evaluated via POSAS.According to the POSAS scores,pregnant women with POSAS≥56 were assigned to the severe scar group(study group,n=50),and those with POSAS<56 to the mild scar group(control group,n=50).The two groups were investigated for the general condition and pelvic adhesion at surgery,short-term postpartum complications,and postoperative scarring of uterine incision.Results:The study group experienced longer operation duration and time from laparotomy to fetal delivery,more blood loss at surgery,and higher chance of pelvic adhesion,compared with the control group.The study group presented significantly lower proportion of patients with mild pelvic adhesion and higher proportions of patients with moderate and severe pelvic adhesion than did the control group(all P<0.05).There was no significant difference in the incidence of short-term postpartum hemorrhage,puerperal infection,abdominal wound infection,incomplete intestinal obstruction,bladder or intestinal injury between the two groups(all P>0.05).Conclusion:POSAS assessment of the abdominal wall scars offers high predictive value for pelvic adhesions in women undergoing repeat cesarean delivery.
作者
吴淑贞
秦竞霞
陈婷
李杨
王惠云
Wu Shuzhen;Qin Jingxia;Chen Ting;Li Yang;Wang Huiyun(Department of Obstetrics,Foshan Maternal and Children’s Hospital,Foshan 528000,Guangdong,China)
出处
《广州医科大学学报》
2019年第2期58-61,共4页
Academic Journal of Guangzhou Medical University
基金
佛山市卫生和计生局医学科研课题(20180121)
关键词
腹壁瘢痕POSAS评估
再次剖宫产
盆腔粘连
预测价值
POSAS assessment,abdominal wall scar
repeat cesarean delivery
pelvic adhesion
predictive value