剖宫产后再次妊娠并发症及其影响因素分析  

Complications and influencing factors of re-pregnancy after cesarean section

作　　者：张彩萍[1] 陈萍[2] 褚晓蒙[1] Zhang Caiping;Chen Ping;Chu Xiaomeng(Department of Disease Control,the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院疾病控制科,郑州450000 [2]河南中医药大学第一附属医院妇产科,郑州450000

出　　处：《中国实用医刊》2020年第24期29-31,共3页Chinese Journal of Practical Medicine

摘　　要：目的分析剖宫产后再次妊娠的并发症及其影响因素。方法抽取2017年1月至2019年6月河南中医药大学第一附属医院剖宫产后再次妊娠再次剖宫产产妇300例设为研究组,并抽取同期初次选择剖宫产的再次妊娠产妇300例设为参照组,比较两组手术时间、术中出血量、分娩时间、不良妊娠结局及并发症发生率,并分析剖宫产后再次妊娠并发症的影响因素。结果研究组手术时间、分娩时间长于参照组,术中出血量多于参照组(P<0.05);研究组不良妊娠结局发生率高于参照组(P<0.05);研究组产后出血、盆腔或腹腔粘连、子宫破裂发生率高于参照组(P<0.05)。研究组宫缩乏力、胎盘前置、胎盘植入、胎盘粘连、胎盘组织处于瘢痕处、瘢痕处于子宫下段的发生率高于参照组(P<0.05)。结论剖宫产后再次妊娠产妇不良妊娠结局发生率、并发症发生率较高,并发症与剖宫产造成腹腔及盆腔结构影响、瘢痕子宫子宫壁解剖结构受损、胎盘亲瘢痕组织生长特性等因素相关。Objective To analyze the complications and influencing factors of re-pregnancy after cesarean section.Methods A total of 300 cases of women who underwent repeated cesarean section of re-pregnancy after cesarean section from January 2017 to June 2019 were selected as the study group,and 300 cases of women who underwent cesarean section for the first time were selected as the reference group.The operation time,intraoperative bleeding,delivery time,adverse pregnancy outcome and complication rate were compared between the two groups,and the influencing factors of the complications of re-pregnancy after cesarean section were analyzed.Results The operation time and delivery time of the study group were longer than those of the control group,and the amount of intraoperative bleeding was more than that of the control group(P<0.05).The incidence of adverse pregnancy outcome in the study group was higher than that of the control group(P<0.05).The incidence of postpartum hemorrhage,pelvic or abdominal adhesion and uterine rupture in the study group was higher than that in the control group(P<0.05).The incidence of uterine atony,placenta previa,placenta implantation,placenta adhesion,placenta tissue in scar and scar in lower segment of uterus in study group was higher than that in control group(P<0.05).Conclusions The incidence of adverse pregnancy outcome and complications in women with re-pregnancy after cesarean section is high,the complications are related to abdominal and pelvic cavity structure,uterine wall injury and growth characteristics of scar tissue in placenta.

关 键 词：剖宫产 瘢痕子宫 再次妊娠 产后出血 盆腔粘连 

分 类 号：R719.8[医药卫生—妇产科学] R714.2[医药卫生—临床医学]