摘要
目的探讨瘢痕子宫再次妊娠剖宫产对母婴的影响及并发症情况。方法选择南京医科大学附属江宁医院2010年4月至2013年6月收治的瘢痕子宫再次妊娠孕妇160例,行再次剖宫产;选择同期初次剖宫产孕妇160例进行对照研究,分析瘢痕子宫再次妊娠剖宫产对母婴结局的影响。结果瘢痕子宫再次剖宫产组手术时间、产时出血量、住院时间显著高于对照组(t值分别为5.843、6.494、3.961,均P<0.05),而切口甲级愈合率显著低于对照组(x^2=3.983,P<0.05)。两组新生儿Apgar评分差异无统计学意义(t=0.034,P>0.05),且新生儿窒息和感染情况差异无统计学意义(x^2值分别为0.196、0.904,均P>0.05)。但术后观察显示再次剖宫产组产后出血、胎盘植入、盆腔粘连等并发症发生率明显高于初次剖宫产组(x^2值分别为4.214、3.865、16.483,均P<0.05)。结论瘢痕子宫再次妊娠剖宫产并发症明显增多,尤其对产妇影响较大,临床应加强剖宫产指征的控制,对于瘢痕子宫再次妊娠要慎重选择剖宫产,以减少再次剖宫产的远期并发症。
Objective To investigate the influence of uterine scar re-pregnancy caesarean section on maternal and neonatal outcomes and its complications.Methods From April 2010 to June 2013 160 cases of women with uterine scar re-pregnancy hospitalized in Jiangning Affiliated Hospital of Nanjing Medical University were selected, and they underwent caesarean section.Another 160 pregnant women undergoing initial cesarean in corresponding period were selected for control study.The influence of repeated caesarean section on maternal and neonatal outcomes was analyzed.Results The operation time, intrapartum hemorrhage, hospitalization time of re-caesarean group were significantly more than the control group （t value was 5.843, 6.494 and 3.961, respectively, all P〈0.05）, but class A healing rate of incision was significantly lower than the control group （χ^2 =3.983,P 〈0.05）.The Neonatal Apgar scores of two groups were not significantly different （t =0.034,P〉0.05）, and there were no significant differences in neonatal asphyxia and infection rate between two groups （χ^2 value was 0.196 and 0.904, respectively, both P〉0.05）.But the incidence of postpartum hemorrhage, placenta accrete and pelvic adhesions of re-caesarean group was significantly higher than the control group （χ^2 value was 4.214, 3.865 and 16.483, respectively, all P〈0.05）.Conclusion Complications caused by re-caesarean in uterine scar re-pregnancy women increase, and they have large impact on mothers.Clinical indications for cesarean section should be controlled in order to control uterine scar re-pregnancy.And for uterine scar re-pregnancy women, cesarean section should be selected carefully to reduce long-term complications of cesarean section.
出处
《中国妇幼健康研究》
2015年第2期304-306,共3页
Chinese Journal of Woman and Child Health Research
关键词
瘢痕子宫
妊娠
分娩方式
母婴结局
并发症
uterine scar
pregnancy
delivery modes
maternal and neonatal outcomes
complications
作者简介
王进（1972-），女，主治医师，主要从事高危产科方面的工作。
[通讯作者]朱玉香，主任医师。
