剖宫产女性产后月经改变及异常妊娠状况调查  

Postpartum Menstruation and Abnormal Pregnancy Investigation Following Cesarean Delivery in Beijing

作　　者：钱睿亚[1] 陈政弘[2] 张为远[1] 汤丽荣[1] 

机构地区：[1]首都医科大学附属北京妇产医院,100026 [2]首都医科大学北京神经外科研究所流行病学室,100069

出　　处：《医学研究杂志》2017年第2期123-126,共4页Journal of Medical Research

摘　　要：目的研究北京地区不同分娩方式对产后月经的影响及异常妊娠的发生情况。方法选择2013年6月~2014年7月在北京城区6所医院妇科/妇检门诊要求常规体检的20~65岁已生育女性共2649例。按照末次妊娠的分娩方式,分为阴道分娩组1521例,剖宫产组女性1128例。采用自制北京地区产后女性生殖健康状况调查表对研究女性进行面对面调查,调查内容包括研究对象的一般情况及分娩情况、分娩前后的月经状况及产后异常妊娠发生情况。结果调查人群总剖宫产率为42.6%,初次剖宫产的主要指征为社会因素,占总剖宫产率的26.33%。无论何种分娩方式,分娩对产前痛经有较好缓解作用,剖宫产组产后经期延长、经间期出血、经量增多及经量减少的比率与阴道分娩组差异有统计学意义(χ~2=370.122,P=0.000)。阴道分娩及剖宫产后自然流产的发生率没有显著性差异,但剖宫产组继发不孕(χ~2=5.177,P=0.023)及异位妊娠的比率(χ~2=5.057,P=0.025)明显增高。结论北京地区剖宫产率逐年升高(截至2013年底),剖宫产率升高的主要原因是社会因素导致的无指征剖宫产增多。无论何种分娩方式,分娩对产前痛经有较好缓解作用,剖宫产对产后月经有较大影响。剖宫产后继发不孕及异位妊娠的发生率较阴道分娩高。Objective To investigate postpartum menstruation and abnormal pregnancy after different delivery mode of women in Beijing area. Methods A questionnaire based randomized study was conducted between June 30, 2013 to July 1, 2014. 2649 Beijing resident women between 20-65 years old finished this face to face survey which included postpartum menstruation and postpartum abnormal pregnancy situation. Women were categorized as vaginal delivery and cesarean section group. Results Delivery had obvious benefit on prenatal dysmenorrhea women, regardless of the delivery mode, but cesarean influenced postpartum menstruation much more（χ2=370.122, P〈0.001）. After cesarean, the incidence of prolonged bleeding、bleeding between periods、amount increase and amount reduce were all significantly higher than vaginal delivery（P〈0.001）. This study showed no significant difference of early spontaneous abortion between two groups, but cesarean group had a significantly higher ratio of secondary infertility （χ2=5.177, P=0.023） and higher postpartum ectopic pregnancy incidence（χ2=5.057, P=0.025）. Conclusion Cesarean delivery had more side effects on postpartum menstruation and increased the incidence of secondary infertility and ectopic pregnancy.

关 键 词：剖宫产 阴道分娩 并发症 月经改变 异常妊娠 

分 类 号：R71[医药卫生—妇产科学]