意外妊娠终止后继发不孕的原因及影响因素分析

目的:探讨意外妊娠终止后继发不孕的原因及影响因素。方法:以2006年8月～2008年8月到怀化市第一人民医院就诊的82例意外妊娠后继发不孕的妇女作为观察组,进行问卷调查,以同期入院的58例原发性不孕妇女作为对照组,采用SPSS13.0软件进行统计分析。结果:观察组初次性生活年龄早于对照组(P0.001);避孕失败原因依次为未避孕(占57.32%)、避孕套失败(占18.29%)、安全期避孕(10.98%)、体外排精(9.76%);避孕失败后终止妊娠的方式主要为人工流产、药物流产,而输卵管妊娠后继发不孕者亦占一定比例;继发不孕的原因居前4位的分别是输卵管梗阻、慢性输卵管炎、慢性盆腔炎、输卵管积水。结论:意外妊娠终止后继发不孕的主要原因是盆腔炎性疾病后遗症,导致输卵管梗阻或不通畅。初次性生活年龄过早,未避孕或避孕方法不当,多次人工流产、药物流产、输卵管妊娠史是意外妊娠后继发不孕的重要影响因素。

Analysis on the causes and effect factors of secondary infertility after termination of unintended pregnancy

Objective:To explore the causes and effect factors of secondary infertility after termination of unintended pregnancy.Methods:82 women with secondary infertility after termination of unintended pregnancy visiting the hospital from August 2006 to August 2008 were selected as observation group,58 women with primary infertility at the same time were selected as control group,questionnaires were used to survey the women in the two groups,SPSS 13.0 software was used for statistical analysis.Results:The age of first sexual life in observation group was earlier than that in control group(P<0.001);the causes of contraceptive failure included having no contraception(57.32%),failure of condom(18.29%),taking safe period contraception(10.98%) and spermiation out of body(9.76%);the main methods of termination of unintended pregnancy were artificial abortion and induced abortion with medicine,secondary infertility after tubal pregnancy was accounted for a certain proportion;the first four causes of secondary infertility were fallopian tube obstruction,chronic salpingitis,chronic pelvic inflammatory diseases and salpingian dropsy.Conclusion:The main cause of secondary infertility after termination of unintended pregnancy is sequelae of pelvic inflammatory diseases,which induces fallopian tube obstruction;the main effect factors of secondary infertility after termination of unintended pregnancy are young age of first sexual life,no contraception or improper methods of contraception,abortion for many times,medical abortion and history of tubal pregnancy.