前次剖宫产术对再次妊娠影响的临床评价

发布时间：2018-03-25 22:42

本文选题：前次剖宫产术　切入点：妊娠期并发症　出处：《实用妇产科杂志》2017年08期

【摘要】：目的:探讨剖宫产术后再次妊娠时妊娠期并发症的发生及不良分娩结局的情况。方法:选择2012年3月至2015年10月在成都市妇女儿童中心医院诊治的剖宫产术后再次妊娠孕妇5960例为观察组,选择同期非瘢痕子宫再次妊娠分娩经产妇6656例为对照组,回顾性分析比较两组妊娠期并发症的发生情况及分娩后母儿情况。结果:观察组前置胎盘、胎盘植入、妊娠期高血压疾病、早产、胎膜早破、胎儿生长受限的发生率均高于对照组(P0.05),观察组重型胎盘植入(穿透型、植入型)的发生率高于对照组(P0.05)。观察组产后输血、子宫切除、产褥感染的发生率均明显高于对照组(P0.05),两组产后出血率及新生儿窒息率差异无统计学意义(P0.05)。结论:剖宫产术增加了再次妊娠时妊娠期并发症及不良分娩情况的发生率,并且可能是导致重型胎盘植入的主要原因之一。严格控制首次剖宫产有助于改善母婴结局。
[Abstract]:Objective: to investigate the occurrence of complications during pregnancy after cesarean section and the adverse outcome of delivery. Methods: from March 2012 to October 2015, cesarean section was performed in Chengdu Women's and Children's Center Hospital. 5960 pregnant women were treated as observation group. A total of 6656 pregnant women were selected as the control group. The incidence of pregnancy complications and postpartum pregnancy were retrospectively analyzed and compared. Results: placenta previa and placenta accreta were observed and compared in the observation group. The incidence of hypertension complicating pregnancy, premature delivery, premature rupture of membranes and fetal growth restriction was higher than that of control group (P 0.05), and the incidence of severe placenta accreta in observation group was higher than that in control group (P 0.05). The incidence of puerperal infection was significantly higher than that of control group (P 0.05). There was no significant difference in the rate of postpartum hemorrhage and neonatal asphyxia between the two groups. Conclusion: cesarean section increases the incidence of complications during pregnancy and bad delivery. And may be one of the main causes of severe placenta accreta. Strict control of first-time cesarean section can help improve maternal and child outcomes.
【作者单位】：成都市妇女儿童中心医院;
【分类号】：R714.2

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