妊娠合并完全性子宫破裂10例临床分析  

Clinical analysis of 10 cases of pregnancy combined with complete uterus rupture

作　　者：王马列[1] 祝彩霞[1] 梁润彩[1] 

机构地区：[1]中山大学附属第一医院妇产科,广州510080

出　　处：《新医学》2016年第8期558-562,共5页Journal of New Medicine

摘　　要：目的探讨妊娠合并完全性子宫破裂的临床特点。方法收集近10年间中山大学附属第一医院产科收治的10例妊娠合并完全性子宫破裂患者的临床资料,归纳、分析其临床特点。结果10例妊娠合并完全性子宫破裂患者中,瘢痕子宫6例,其中剖宫产术后瘢痕子宫1例、子宫肌瘤或腺肌瘤剔除术后瘢痕子宫5例;胎盘植入3例,其中合并单角子宫1例、有人工流产史1例;余1例患者无明确相关病史。10例中,表现为持续性下腹痛6例,其余4例无典型子宫破裂的临床表现;产后出血7例,输红细胞6例,子宫切除3例,无产妇死亡;胎死宫内4例,早产3例,其中新生儿重度窒息1例。结论瘢痕子宫是妊娠完全性子宫破裂的重要原因。完全性子宫破裂多以持续性下腹痛为首发症状,母胎妊娠结局差。妊娠期急腹症患者应首先排除子宫破裂,对于存在明确相关病史或可疑子宫破裂的患者,应加强监测并及时处理。Objective To investigate the clinical characteristics of pregnancy combined with complete uterine rupture. Method A retrospective analysis of 10 cases of pregnacy combined with complete uterine rupture were carried out in recent 10 years in obstetrics department of the First Affiliated Hospital of SunYat-sen University,and the clinical data were summarized and analyzed. Results There were 6 cases of scarred uterus in 10 cases of complete rupture of uterine,which included 1 case of scar uterus after cesarean section,5 cases of scar uterus after excision of uterine myoma or adenomyoma. There were 3 cases of placenta impantation,among which,1 cases had single angle uterus,1 cases had a history of artificial abortion,and 1patients had no specific history. 6 pregnancy cases of complete uterine rupture（ 6 /10） had a characterized manifestation as persistent lower abdominal pain,while the rest（ 4 /10） had no typical manifestations. All of the lying-in women survived,including 7 cases of postpartum hemorrhage,6 cases of transfusion of red blood cells,3 cases of performing hysterectomy. There were 4 cases of dead fetus in uterus,3 cases of premature labor including 1 cases of severe asphyxia of newborn. Conclusions Scarred uterus was the most important cause of complete uterine rupture. The initial symptom of complete uterine rupture was persistent lower abdominal pain,the pregnancy outcome is poor. Pregnancy patients with acute abdomen should first exclude uterine rupture. It＇s supposed to strengthen the monitoring and take treatment in time when there is a related history or patients with suspicious uterine rupture.

关 键 词：妊娠 子宫破裂 完全性 高危因素 诊断 临床特点 

分 类 号：R714.2[医药卫生—妇产科学]