瘢痕子宫对再次妊娠分娩结局及并发症发生率的影响

目的探讨瘢痕子宫对再次妊娠产妇分娩结局及并发症发生率的影响。方法260例瘢痕子宫再次妊娠产妇作为观察组,选择同期260例非瘢痕子宫再次妊娠产妇作为对照组。对比两组产妇再次妊娠所选择的分娩方式及并发症发生情况。结果观察组剖宫产占比95.8%、产后出血占比9.2%、子宫切除占比2.7%、产后感染占比3.1%、胎盘前置或植入占比4.2%,均明显高于对照组的10.4%、3.8%、0.4%、0.4%、1.2%,差异具有统计学意义(P<0.05)。观察组主要心脑血管不良事件(MACCE)占比为1.5%与对照组的1.9%对比,差异无统计学意义(P>0.05)。结论适当终止妊娠在解决母婴处于危急状态、保障其安全方面具有重要作用,极大降低了母婴围生期死亡率。剖宫产后形成瘢痕子宫,导致一些并发症发生率提高,对再次妊娠产妇的影响不容忽视。因此一定要严格把握剖宫产手术的适应证与禁忌证,降低剖宫产率,提高产妇再次妊娠时的安全性。

Effect of scarred uterus on delivery outcome and complication rate of second pregnancy

Objective To discuss the effect of scarred uterus on delivery outcome and complication rate of second pregnancy.Methods There were 260 cases of previous cesarean section selected as the observation group,another 260 re-pregnant women with scarred uterus taken as the observation group,and 260 re-pregnant women with non-scarred uterus during the same period as the control group.The delivery mode and occurrence of complications of the two groups were compared.Results In the observation group,cesarean section accounted for 95.8%,postpartum hemorrhage accounted for 9.2%,hysterectomy accounted for 2.7%,postpartum infection accounted for 3.1%,placenta previa or implant accounted for 4.2%,which were significantly higher than 10.4%,3.8%,0.4%,0.4%and 1.2%of the control group,and the difference was statistically significant(P<0.05).The proportion of major adverse cardiovascular and cerebrovascular events(MACCE)in the observation group was 1.5%,which had no statistically significant difference compared with 1.9%in the control group(P>0.05).Conclusion Appropriate termination of pregnancy plays an important role in solving the critical state of mother and infant and ensuring their safety,which greatly reduces the perinatal mortality of mother and infant.The formation of scar uterus after cesarean section leads to the increase of the incidence of some complications,which can not be ignored.Therefore,we must strictly grasp the indications and contraindications of cesarean section,reduce the rate of cesarean section,and improve the safety of re-pregnancy.