瘢痕子宫再次剖宫产的并发症分析及对母婴影响的临床研究

目的探讨瘢痕子宫再次剖宫产时并发症情况及对母婴的影响。方法选取2013~2015年该院收治104例瘢痕子宫再次妊娠并行剖宫产手术的产妇作为观察组,另选择同期初次剖宫产产妇104例作为对照组。观察两组产妇手术时间、术中出血量、切口愈合情况、住院时间,以及新生儿出生后第1、5min的Apgar评分、新生儿窒息和感染情况及产妇产后出血、产褥期感染、盆腔粘连、胎盘植入及手术损伤等并发症情况。结果对照组产妇手术时间、术中出血量及住院时间明显少于观察组,差异有统计学意义(P0.05)。两组产妇术后切口甲级愈合差异无统计学意义(P0.05)。两组新生儿感染差异无统计学意义(P0.05)。两组新生儿窒息、出生后1min和5min的Apgar评分差异有统计学意义(P0.05)。观察组产妇产后出血、产褥期感染、盆腔粘连、胎盘植入及手术损伤等相关并发症高于对照组,差异均有统计学意义(P0.05)。结论瘢痕子宫再次妊娠剖宫产时并发症较多,风险较大,对母婴影响也较大。临床上应当严格把握剖宫产手术指征,以减少瘢痕子宫再次剖宫产的产妇。

Complications of cesarean uterine scar again and clinical research on the impact of the mother and infant

Objective To study the complications of cesarean uterine scar again ,and clinical research on the impact of the mother and infant .Methods From 2013 to 2015 ,104 cases of uterine scar pregnancy again ,concurrent cesarean section pregnant women in the hospital were selected as the observation group .Another 104 cases of pregnant women were selected as the control group .The operation time ,intraoperative bleeding ,wound healing ,time of hospitalization ,after the birth of the 1 and 5 min Apgar score ,neo‐natal asphyxia and infection and postpartum hemorrhage ,puerperal infection ,pelvic adhesion ,placenta implantation and surgical in‐jury and other complications between the two groups were observed and compared .Results The operation time ,the amount of bleeding during operation and hospitalization time of control group were significantly less than the observation group (P<0 .05) . There was no significant difference in grade A healing between the two groups (P>0 .05) .There was no significant difference in infection between the two groups (P>0 .05) .There was significant difference in neonatal asphyxia ,Apgar score of 1 min and 5 min after birth(P<0 .05) .The postpartum hemorrhage ,puerperal infection ,pelvic adhesion ,placenta implantation and surgical injury and other related complications of observation group were higher than the control group (P<0 .05) .Conclusion The complications of cesarean uterine scar again are more during pregnancy ,with greater risk ,greater impact on maternal and infant .In clinical prac‐tice ,we should strictly control the indications of cesarean section in order to reduce the cesarean section of scar uterus .