子宫下段剖宫产术切口处妊娠终止大出血临床分析

目的:探讨子宫下段剖宫产术切口处妊娠终止大出血的病例特点和诊治方法。方法:回顾性分析2004年至2007年间的6例子宫下段剖宫产术切口处妊娠终止大出血的病例资料。结果:5例停经后有阴道不规则出血;3例于人工流产术中和1例无阴道出血史的在药物流产时发生大出血,用甲氨蝶呤(MTX)和米非司酮保守治疗,2例有效,2例行子宫全切除术;另2例至中期妊娠终止时发生子宫破裂,行子宫全切除术。结论:剖宫产再次妊娠,有发生子宫下段剖宫产术切口处妊娠的危险;应及早诊治;早期用MTX和米非司酮保守治疗,有一定疗效。严格剖宫产指征,重视产后避孕是主要的预防方法。

Analysis on the Hemorrhage Caused by Termination of Ectopic Pregnancy at the Incision of Lower Segment Cesarean Section

Objective: To study the features and measurement for the hemorrhage caused by termination of ectopic pregnancy at the incision of lower segment cesarean section.Method: We reviewed 6 cases data.Result: 5 cases with irregular vaginal bleeding after menolipsis.The hemorrhage occured during induced abortion(3 cases) and one case in drug abortion.After taking MTX and misoprostal,2 cases was effective.2 cases undewent hysterectomy.The other 2 cases underwent hysterectomy for the urterus rupture during the midterm of terminiation of pregnancy.Conclusion: There's risk in the ectopic pregnancy at the incision of lower segment cesarean section for the cases with history of cesarean section.To use MTX and misoprostol early if the abnormal status exists.And the preventive method is to pay attention on the contraception after labor.