不同妊娠间隔时间的瘢痕子宫孕妇子宫瘢痕愈合情况和分娩结局  

Uterine Scar Healing and Delivery Outcomes in Pregnant Women with Scarred Uterus and Different Gestational Interval

作　　者：王艳 聂金花 周丽萍 WANG Yan;NIE Jinhua;ZHOU Liping(Department of Function Yichun People's Hospital,Yichun 336000,China)

机构地区：[1]宜春市人民医院功能科,江西宜春336000

出　　处：《中国医学创新》2025年第4期130-134,共5页Medical Innovation of China

摘　　要：目的:观察不同妊娠间隔时间的瘢痕子宫孕妇子宫瘢痕愈合情况和分娩结局。方法:选取2021年10月—2023年10月宜春市人民医院70例瘢痕子宫孕妇为研究对象,根据距离上次妊娠间隔时间,分为A组(2年<间隔时间≤3年)22例,B组(3年<间隔时间≤6年)30例,C组(6年<间隔时间≤10年)18例;通过彩超检查并比较三组子宫瘢痕愈合情况,观察三组阴道试产成功率、分娩情况及母婴结局。结果:三组子宫瘢痕愈合分级比较差异有统计学意义,A组与C组比较差异有统计学意义(P<0.05);三组阴道试产成功率比较,差异有统计学意义,A组、B组阴道试产成功率均高于C组(P<0.05);三组缩宫素用量、术中出血量比较,差异均有统计学意义(P<0.05),A组缩宫素用量低于B组、C组,B组缩宫素用量低于C组,A组术中出血量高于C组(P<0.05);三组住院时间比较,差异有统计学意义(P<0.05),A组、B组住院时间均低于C组(P<0.05)。A组子宫破裂发生率低于C组(P<0.05)。结论:距离上次妊娠间隔时间2~6年的瘢痕子宫孕妇瘢痕愈合情况更好,阴道试产成功率较高,缩宫素用量与术中出血量较少,子宫破裂风险较低,分娩安全性更高。Objective:To observe uterine scar healing and delivery outcomes of pregnant women with scarred uterus at different gestation intervals.Method:Seventy pregnant women with scarred uterus in Yichun People's Hospital from October 2021 to October 2023 were selected as the study objects.According to the interval time since the last pregnancy,22 cases were divided into group A(2 years<interval time≤3 years),group B(3 years<interval≤6 years)30 cases,group C(6 years<interval≤10 years)18 cases.The healing of uterine scar in the three groups was examined by color ultrasound and compared.The success rate of vaginal trial labor,delivery situation and maternal and infant outcomes were observed.Result:There were significant differences in the grading of uterine scar healing among the three groups,and the difference was also statistically significant between group A and group C(P<0.05).The difference in success rate of vaginal trial labor among the three groups was statistically significant,and which was higher in group A and group B than group C(P<0.05).There were statistically significant differences in the amount of Oxytocin and intraoperative blood loss among the three groups(P<0.05).The amount of Oxytocin in group A was lower than that in group B and group C,the amount of Oxytocin in group B was lower than that in group C,and the amount of blood loss in group A was higher than that in group C(P<0.05).There were significant differences in length of hospital stay among the three groups(P<0.05),and which was shorter in group A and group B than group C(P<0.05).The incidence of uterine rupture in group A was lower than that in group C(P<0.05).Conclusion:Pregnant women with scarred uterus who are 2 to 6 years from the last pregnancy have better scar healing,higher success rate of vaginal trial labor,less uterine hormone dosage and intraoperative blood loss,lower risk of uterine rupture,and higher safety of delivery.

关 键 词：瘢痕子宫 再次妊娠 分娩结局 

分 类 号：R714.22[医药卫生—妇产科学]