妊娠子宫破裂(附47例分析)

回顾分析我院１９６３年１月～１９９４年１２月收治的４７例子宫破裂的临床资料，发生率０．０８％。初产妇４例（８．５％），经产妇４３例（９１．５％）。妊娠期破裂１０例（２１．３％），分娩期破裂３７例（７８．７％），完全破裂２９例（６１．７％），不全破裂１８例（３８．３％）。子宫疤痕破裂２２例（４６．９％）占其首位，梗阻性难产１５例（３１．９％），病理性子宫破裂５例（１０．６％），损伤性破裂４例（８．５％）及催产素使用不当１例。围产儿死亡３１例包括死胎２８例，死产２例，新生儿死亡１例。围产儿死亡率６３３．０‰（３１／４９，２例双胎），孕妇死亡１例。文章重点讨论诊断及预防。

RUPTURE OF THE PREGNANT UTERUS (ANALYSES OF 47 CASES)

The clinical data of 47 cases of rupture in the pregnant uterus between Jan, 1963 to December, 1994 were analyzed in our hospital. The incidence was 0.08%.There were 4 nulliparous and 43 multigravid. Ten(21.3%)patients sustanined uterine rupture prior to labor and 37(78.7%) during the course of labor. 29(61.7%) patients had complete uterine tears and 18(38.3%) incomplete. In this study, the most common factors were:1)rupture of uterin scar, 46.8%(22/47) 2) obstricted dystocia, 31.9%(15/47);3) rupture of pathological uterine, 10.6%(5/47);4)injuried rupture, 8.5%(4/47) and use of oxytocin 0.2%(1/47).There were 31 perinatal deaths including 28 fetal deaths, 3 still births and 1 neonatal death. The perinatal mortality was 63.3%(31/49,twin 2 cases). There was 1 maternal death in the serios. In present report, the diagnosis and prevention of uterin rupture were discussed.