带环妊娠的危险因素及临床特点分析  

Risk Factors and Clinical Features of Pregnancy in IUD Users:A Case-control Study

作　　者：董欢 陆海茜 陈勤芳[1] 周青[1] 刘英 张晨[1] 何晓英 DONG Huan;LU Haiqian;CHEN Qinfang(Family Planning Department,International Peace Maternity and Child Health Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai Key Laboratory of Embryo Original Diseases,Shanghai Municipal KeyClinical Specialty,Shanghai 200030,China)

机构地区：[1]上海交通大学医学院附属国际和平妇幼保健院计划生育科上海市胚胎源性疾病重点实验室上海市临床重点专科(建设项目)——"强主体"妇产科

出　　处：《实用妇产科杂志》2019年第5期376-381,共6页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨带环妊娠的危险因素及临床特点。方法:收集2012年1月至2018年1月在我院接受治疗的82例带环妊娠患者作为带环妊娠组,170例带环未妊娠者作为对照组,排除拒绝参与该临床研究及临床资料提供不全者,采用1∶2病例对照研究探讨带环妊娠的危险因素及临床特点。结果:多因素Logistic回归分析显示,带环妊娠危险因素包括节育器位置异常(OR8.705,95%CI4.130~18.346)、子宫腔深>8.5cm(OR5.816,95%CI1.365~24.788)及子宫畸形(OR6.751,95%CI1.483~30.734),而放置左炔诺孕酮宫内节育系统(OR0.113,95%CI0.013~0.967)是其保护因素。带环妊娠中偏宫角妊娠、异位妊娠及切口妊娠的发生率均较高,分别为6.1%、4.9%及6.1%。结论:节育器位置异常、子宫腔深>8.5cm、子宫畸形是带环妊娠的危险因素,放置左炔诺孕酮宫内节育系统是其保护因素。带环妊娠中偏宫角妊娠、异位妊娠及切口妊娠的发生率均较高。该研究可指导预防并减少带环妊娠及其相关妊娠合并症的发生率。Objective:To investigate the risk factors and clinical features of pregnancy in intrauterine device(IUD)users.Methods:A case-control study was conducted from January 2012 to January 2018.82 women with an IUD and a confirmed pregnancy were recruited as the case group,170 women with IUDs and who were not pregnant were matched as controls at a ratio of 1∶2.Women who refused interviews or provided incomplete information were excluded.Results:Multivariate Logistic regression analysis showed that the displacement of the IUD(OR 8.705,95%CI 4.130-18.346),uterine cavity depth(>8.5 cm)(OR 5.816,95%CI 1.365-24.788)and uterine malformation(OR 6.751,95%CI 1.483-30.734)were risk factors of IUD failure.Levonorgestrel intrauterine system(OR 0.113,95%CI 0.013-0.967)was a protective factor.In addition,the IUD induced high incidence of pregnancy with gestational sac near the horn of uterus,ectopic pregnancy and cesarean scar pregnancy,with 6.1%,4.9%and 6.1%respectively.Conclusions:The displacement of the IUD,Uterine cavity depth(>8.5 cm)and uterine malformation are risk factors of IUD failure.while levonorgestrel intrauterine system is a protective factor.The IUD can induce high incidence of pregnancy with gestational sac near the horn of uterus,ectopic pregnancy and cesarean scar pregnancy.

关 键 词：妊娠 宫内节育器 危险因素 

分 类 号：R714.2[医药卫生—妇产科学]