第三次剖宫产19例临床分析

剖宫产作为母胎紧急状况下终止妊娠的急救措施，阴道生产这外的补救分娩方式，已经是产科非常基本的手术，也是世界范围妇女们接受的最普遍的手术。近年部宫产率多数医院在40-60％，明显高于WHO提出的不大于15％的标准。剖宫产是一种创作性破坏性手术，有诸多不安全因素及并发症，3次剖宫产的严重并发症是出血及子宫破裂，直接危及孕产妇的生命安全。故首次剖宫产要打破“一次剖宫产，永远剖宫产”的概念。只要第一次剖宫产指征无存在，本次妊娠又无新的指征出现，无严重的妊娠并发症或合并症，此次妊娠距前次手术2年以上，前次手术为下段横切口且愈合良好的病例，在专人严密观察下尽量试产，有先兆子宫破裂征象时行手术。有2次以上剖宫产史的孕妇，在准备好输血，子宫切除等抢救的情况下，最好行择期剖宫产。因为手术次数越多，妊娠期及分娩期期发生子宫破裂的机率就越大，母儿并发症越多。

Third time splits the palace to produce 19 example clinical analysis

Splits the palace to produce took under the mother＇s womb urgent condition the termination pregnancy first aid meas- ure,the vagina produces outside this the recovery childbirth way, was already the obstetrics extremely basic surgery,also is the most universal surgery which the worldwide scale women accept. Recent years the palace production rate most hospitals in 40--60 %, ob- viously were higher than WHO to propose are not bigger than 15%standard. Splits the palace to produce is one kind of creative de- structive surgery, some many safety factors and the complication, 3 times split the serious complication which the palace produces are the hemorrhage and the rupture of uterus, endangers the pregnant woman directly the safety. Therefore splits the palace to produce for the first time must break ＂one time splits the palace to produce,forever splits the palace produces＂ the concept. So long as first time splits the palace to produce refers drafts none left in, this pregnancy not new refers drafts the appearance, the not serious preg- nancy complication or the complications, this pregnancy was apart from recently above the surgery for 2 years, recently the surgery for the lower segment horizontal margin also cicatrization good case of illness, under the specialist strict observation as far as possi- ble the trial production,had the omen rupture of uterus sign fashionable surgery. Above some 2 times splits the pregnant woman who the palace produces the history, in prepares to transfuse blood,rescue in and so on womb excision situations, the best line picks an auspicious date splits the palace to produce. Because the surgery number of times are more,the gestation period and the childbirth has the rupture of uterus probability to be bigger successively, the mother complication are more.