3613例瘢痕子宫再次妊娠分娩结局分析  

Outcome Analysis of 3613 Cases of Second Pregnancy with Scarred Uterus

作　　者：施凤 余韦 SHI Feng;YU Wei(Jiangsu Health Vocational College,Nanjing 210029,China;Women’s Hospital of Nanjing Medical University,Nanjing Women and Children’s Health Care Hospital,Nanjing 210029,China)

机构地区：[1]江苏卫生健康职业学院,南京210029 [2]南京医科大学附属妇产医院,南京市妇幼保健院,南京210029

出　　处：《宁夏医科大学学报》2023年第12期1272-1275,共4页Journal of Ningxia Medical University

摘　　要：目的探讨瘢痕子宫对再次妊娠分娩结局的影响。方法回顾性收集3613例瘢痕子宫临床资料,按最终的分娩方式分为选择性再次剖宫产(ERCS组)和剖宫产后阴道分娩(VBAC组)组,分析两组妊娠期、分娩期的合并症及并发症发生情况。结果3613例瘢痕子宫再次妊娠,妊娠分娩合并症和并发症的发病率前10位依次是妊娠糖尿病(26.7%)、贫血(22.5%)、胎膜早破(13.1%)、产后出血(8.8%)、早产(6.7%)、巨大儿(6.5%)、妊娠高血压(6.4%)、前置胎盘(4.6%)、臀位(4.3%)及妊娠合并子宫肌瘤(3.8%)。ERCS组妊娠高血压、臀位、前置胎盘、产后出血发病率均高于VBAC组(P均<0.05);而VBAC组的妊娠合并甲状腺功能减退、胎膜早破、早产、子宫破裂发病率均高于ERCS组(P均<0.05)。结论瘢痕子宫会增加再次妊娠分娩合并症与并发症的发生,分娩方式的选择需权衡利弊,以改善母婴预后。Objective To investigate the effect of scarred uterus on the outcome of second pregnancy.Methods The data of 3613 pregnant women with scarred uterus were collected retrospectively.According to the mode of delivery,they were divided into two groups:elective repeat cesarean section(ERCS)group and vaginal birth after cesarean(VBAC)group.The complications of pregnancy and delivery in the two groups were analyzed.Results 3613 cases of scarred uterus were pregnant again,the incidence rate of pregnancy complications was from high to low,the top ten were gestational diabetes mellitus(26.7%),anemia(22.5%),premature rupture of membranes(13.1%),postpartum hemorrhage(8.8%),premature delivery(6.7%),macrosomia(6.5%),gestational hypertension(6.4%),placenta previa(4.6%),Breech position(4.3%)and pregnancy complicated with hysteromyoma(3.8%).The incidence rate of hypertensive disorder complicating pregnancy,breech presentation,placenta previa and postpartum hemorrhage in ERCS group was higher than that in VBAC group(P all<0.05).The incidence rate of pregnancy with hypothyroidism,premature rupture of membranes,premature delivery and uterine rupture in VBAC group was higher than that in ERCS group(P all<0.05).Conclusion Scarred uterus increases the incidence of complications of second pregnancy and delivery.The choice of delivery mode needs to weigh the advantages and disadvantages in order to improve the prognosis of mother and infant.

关 键 词：瘢痕子宫 选择性再次剖宫产 剖宫产后阴道分娩 妊娠分娩结局 

分 类 号：R714[医药卫生—妇产科学]