西部非洲妇女妊娠晚期子宫破裂47例的临床分析

目的探讨西部非洲妇女妊娠子宫破裂发生的原因以及防治措施。方法回顾分析西部非洲尼日尔马拉迪医院2008．11—2010．11收治子宫破裂患者47例的临床资料。结果47例中产妇死亡4例，治愈43例，病死率为8．5％。不完全性子宫破裂5例，胎儿存活。完全性子宫破裂42例中，3例胎盘未剥离，胎儿存活；其余39例胎儿均死亡，占83．0％。4例剖宫产术后4～30d出现膀胱阴道瘘。结论妊娠子宫破裂如果能早期诊断，及时手术，可降低孕妇及胎儿死亡率。熟练处理阴道难产，合理使用催产素，能最大限度地预防子宫破裂的发生。

Clinical analysis of 47 cases of uterine rupture in 13re,nancy at term in west african area

Objective To study the cause and preventive measures of uterine rupture during the pregnancy. Methods The clinical data of 47 cases of uterine rupture in late pregnancy in Maradi hospital （Niger, west african area） from November 2008 to November 2010 were retrospectively analyzed. Results Forty-three cases were cured completely, another 4 cases were dead. The mortality rate was 8.5%. The fetuses in 5 eases of incomplete uterine rup- ture were all alive. In 42 cases of complete uterine rupture, the fetuses in 3 cases without placental separation were alive. The others （39 fetuses） all were dead. The mortality rate of fetus was 83.0%. There were 4 cases of vesicovagi-nal fistulae between 4 and 30 days after cesarean section. Conclusion It would lower the fetal or maternal mortality rate if the diagnosis of uterine rupture could be gotten earlier during the pregnancy period, for surgical management be- ing performed in time. It is urgent for the physicians all over the world to lower the caesarean section rate for decreasing the risk of scar rupture in subsequent pregnancies. At the same time, skilled management of difficult vaginal delivery, as well as rational use of nxytocin, could decrease the incidence of uterine rupture.