剖宫产切口与非剖宫产切口子宫破裂探讨  

Discussion of the Characteristics and Prognosis of Uterine Rupture at the Previous Uterine Cesarean Section Scar or Non-Cesarean Section Scar Location

作　　者：郝丽英[1] 张惠[1] HAO Liying;ZHANG Hui(Department of Perinatal Medicine,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院围产医学部,北京100026

出　　处：《医学综述》2018年第21期4342-4345,共4页Medical Recapitulate

摘　　要：目的探讨不同部位子宫破裂的特点及预后。方法对2011年1月至2017年12月首都医科大学附属北京妇产医院围产医学部收治的28例子宫破裂患者的临床资料进行回顾性分析。结果剖宫产切口子宫破裂(15/128 242)的发生率与非剖宫产切口子宫破裂(13/128 242)大致相等,约为0. 01%。与非剖宫产切口子宫破裂组比较,剖宫产切口子宫破裂组发生孕周晚[38. 0(27. 0,40. 0)周比29. 0(26. 5,36. 5)周],从症状出现到胎儿娩出时间短[23(11,218) min比240(185,675) min](P <0. 05),而在年龄、流产史、子宫破裂口大小、出血量、子宫切除情况、孕产妇死亡及胎儿或新生儿结局方面两组差异无统计学意义(P> 0. 05)。结论非剖宫产切口子宫破裂发生孕周更早,早产比例更高,手术前延误的时间更长。但无论何种部位子宫破裂,孕产妇除子宫切除外,无其他严重不良结局,而胎儿或新生儿不良结局比例较高。Objective To investigate the characteristics and prognosis of uterine rupture at the previous uterine cesarean section scar or non-cesarean section scar location. Methods Clinical data of 28 cases with uterine rupture in Beijing Obstetrics and Gynecology Hospital, Capital Medical University, from Jan. 2011 to Dec. 2017, were studied retrospectively. Results The incidence of uterine rupture at previous cesarean section scar（15/128 242） was not statistically different from that at a non-cesarean section scar（13/128 242）,which was about 0.01%.Compared to the uterine rupture at a non-cesarean section scar location,uterine rupture at previous cesarean section scar group happened at a later gestational age[38.0（27.0,40.0） gestational week vs 29.0（26.5,36.5） gestational week],with a higher rate of term delivery,and significantly shorter interval from symptoms showing up to delivery [23（11,218） min vs 240（185,675） min]（ P 〈0.05）.There was no statistical difference between the two groups in age of the patients,history of abortion,size of the rupture, volume of bleeding,incidence of hysterectomy,maternal mortality or perinatal outcomes of the fetuses or newborns（ P 〉 0.05 ）. Conclusion Uterine rupture at a non-cesarean section scar location happened at an earlier gestational week with higher incidence of preterm birth and requiring more time to reach the diagnosis and deliver the babies.However,for patients with uterine rupture at any location,there are no other serious adverse maternal outcome except hysterectomy,while the proportion of fetuses or newborns with bad consequences is high.

关 键 词：子宫破裂 特点 预后 

分 类 号：R714.7[医药卫生—妇产科学]