剖宫产术后瘢痕妊娠发生的危险因素分析

发布时间：2019-03-20 16:38

【摘要】：目的探讨剖宫产术后发生瘢痕妊娠的危险因素。方法采用病例对照研究方法,以48例剖宫产术后瘢痕妊娠(CSP)患者为观察组,随机抽取50例同期有剖宫产史但再次妊娠位置正常患者为对照组。收集临床资料,通过单因素分析和Logistic回归分析,确定剖宫产术后瘢痕妊娠的独立危险因素。结果单因素分析显示两组的学历、终止宫内妊娠以外的盆腹腔手术史、流产次数、末次剖宫/流产时间、早孕期阴道流血差异均有统计学意义(P0.05)。多因素分析发现末次剖宫/流产时间(OR=0.983,95%CI:0.970~0.997)、早孕期阴道流血(OR=35.937,95%CI:15.264~84.611)为CSP发病的独立危险因素。结论对有剖宫产病史的停经患者,首次就诊时应追问人流史及早孕期是否有阴道流血,结合B超等进行早期诊断,从而早期治疗以改善患者预后。
[Abstract]:Objective to investigate the risk factors of scar pregnancy after cesarean section. Methods A case-control study was conducted in 48 cases of (CSP) patients with scar pregnancy after cesarean section. 50 cases with cesarean section history and normal pregnancy position were randomly selected as control group. The clinical data were collected and the independent risk factors of scar pregnancy after cesarean section were determined by univariate analysis and Logistic regression analysis. Results univariate analysis showed that there were significant differences between the two groups in terms of academic background, history of pelvic and abdominal surgery other than termination of intrauterine pregnancy, times of abortion, last caesarean section / abortion time and vaginal bleeding during early pregnancy (P0.05). Multivariate analysis showed that the last caesarean section / abortion time (OR=0.983,95%CI:0.970~0.997) and vaginal bleeding (OR=35.937,95%CI:15.264~84.611) during early pregnancy were independent risk factors for CSP. Conclusion for patients with menopause who have a history of cesarean section, it is necessary to inquire into the history of abortion and whether there is vaginal bleeding during pregnancy at the first visit, and to make early diagnosis combined with B-ultrasound, so as to improve the prognosis of the patients with early treatment.
【作者单位】：重庆市中医院妇产科;重庆市长寿区妇幼保健院妇产科;第三军医大学西南医院妇产科;
【基金】：重庆市卫计委医学科研计划项目(20142068)
【分类号】：R714.22

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