高龄妇女疤痕子宫再次妊娠与非疤痕子宫再次妊娠结局的比较研究
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摘要
目的分析高龄妇女疤痕子宫再次妊娠与非疤痕子宫再次妊娠的结局差异。方法随机选取2014年7月至2017年6月在梧州市红十字会医院接受治疗的高龄产妇疤痕子宫再次妊娠与非疤痕子宫再次妊娠产妇各150例,分别设为研究组和对照组。比较两组人员的妊娠并发症、妊娠合并症、围生儿结局、手术中出血量、术后24小时出血量和恶露时间等的差异。结果研究组和对照组产妇的羊水量异常、前置胎盘、胎盘黏连、子宫肌瘤、手术中出血量、术后24小时出血量和恶露时间比较,其差异均具有统计学意义(均P<0.05)。结论高龄妇女疤痕子宫再次妊娠比非疤痕子宫再次妊娠的风险性更高,产妇需要根据适应症,合理选择顺产或剖宫产。
Objective To analyze the different outcome of the second pregnancy between the scar uterus and the non-scarring uterus in elder women. Methods Each 150 cases of elderly pregnant women with scar uterus and non-scarring uterus, randomly selected from July 2014 to June 2017 in Wuzhou Red Cross Hospital, were regarded as the research group and the control group respectively. The incidence of pregnancy complications, perinatal fetal outcomes, intraoperative blood loss, bleeding volume 24 hours postoperative and lochia time were compared between the two groups. Results There were statistically significant differences in the amniotic fluid volume, abnormal placenta, placenta adhesion, uterine fibroids, intraoperative blood loss, bleeding volume 24 hours postoperative and lochia time between the two groups(all P<0.05). Conclusions The risk of the second pregnancy of the scar uterus in the elder women is higher than that of the non-scarring uterus, so parturient and cesarean section should be chosen reasonably according to the indications.
Objective To analyze the different outcome of the second pregnancy between the scar uterus and the non-scarring uterus in elder women. Methods Each 150 cases of elderly pregnant women with scar uterus and non-scarring uterus, randomly selected from July 2014 to June 2017 in Wuzhou Red Cross Hospital, were regarded as the research group and the control group respectively. The incidence of pregnancy complications, perinatal fetal outcomes, intraoperative blood loss, bleeding volume 24 hours postoperative and lochia time were compared between the two groups. Results There were statistically significant differences in the amniotic fluid volume, abnormal placenta, placenta adhesion, uterine fibroids, intraoperative blood loss, bleeding volume 24 hours postoperative and lochia time between the two groups(all P<0.05). Conclusions The risk of the second pregnancy of the scar uterus in the elder women is higher than that of the non-scarring uterus, so parturient and cesarean section should be chosen reasonably according to the indications.
引文
[1] 梁朝霞,杜蒙恺,陈丹青.高龄妇女再生育的产科合并症风险[J].中国计划生育和妇科,2014,6(7):7-9.
[2] Martin JA,Hanilton BE,Ventura SJ,et al.Births:Final data for 2013[J].Natl Vital Stat Re,2015,64(1):1-65.
[3] 韩悦.疤痕子宫再次妊娠并发妊娠期高血压疾病的妊娠结局分析[J].中国妇幼保健,2013,5(10):1565-1567.
[4] 钱慧.疤痕子宫再次妊娠二次剖宫产与非疤痕子宫剖宫产的对比研究[J].河北医学,2013,4(6):823-826.
[5] Lian F,Wang Y,Chen W,et al.Uterine artery embolization combined with local methotrexate and systemic methotrexate for treatment of cesarean scar pregnancy with different ultrasonographic pattern[J].Cardio Vascular and Interventional Radiology,2012,35(2):286-291.
[6] 杨桂香.剖宫产后疤痕子宫再次妊娠分娩方式的临床探讨[J].河北医学,2013,11(4):1639-1642.
[7] 汪雪雁,张迅.高龄孕妇的孕前与孕期保健[J].实用妇产科杂志,2013,29(1):7-9.
[8] 唐中兰,张文静,韩钰,等.高龄产妇剖宫产术后切口感染的危险因素及预后分析[J].中华医院感染学杂志,2017,27(22):5240-5242.
[9] 徐瑾,陈淑梅,李国梅.高龄产妇妊娠情况的临床研究[J].当代医学,2017,23(32):80-82.
[10] 张蓉华,陈小海,危秀清,等.547例高龄妇女妊娠情况分析[J].海峡预防医学杂志,2012,7(1):34-35.
[11] 阮焱,张为远.剖宫产的现状及剖宫产率高居不下的原因[J].实用妇产科杂志,2015,31(4):241-243.
[12] 李博雅,杨慧霞.剖宫产后阴道分娩相关问题[J].中国实用妇科与产科杂志,2016,32(8):748-753.
[13] 汤斐,赵云.剖宫产后再次妊娠阴道试产子宫破裂风险防范[J].中国妇幼保健,2018,33(2):457-460.
[14] 潘春煦,杨鹏.4117例二次妊振合并疤痕子宫产妇剖宫产并发症情况分析[J].山东医药,2014,54(2):39-40.
[15] 钟致向,蔡敏.疤痕子宫妊娠孕晚期经阴道分娩的临床结局分析[J].白求恩医学杂志,2017,15(5):591- 592.
[16] 陶艳萍,张步振.疤痕子宫阴道分娩的临床分析[J].昆明医科大学学报,2015,36(12):131-133.
[17] 孙彦飞,方浴娟,张薏女.疤痕子宫再次妊娠二次剖宫产与非疤痕子宫剖宫产的对比研究[J].中国性科学,2015,24(6):93-95.
[18] Bosev D,dimitrov A.Changes in uterine myoma dimentions during pregnancy[J].Akush Ginekol (Sofiia),2007,46(5):3-6.
[2] Martin JA,Hanilton BE,Ventura SJ,et al.Births:Final data for 2013[J].Natl Vital Stat Re,2015,64(1):1-65.
[3] 韩悦.疤痕子宫再次妊娠并发妊娠期高血压疾病的妊娠结局分析[J].中国妇幼保健,2013,5(10):1565-1567.
[4] 钱慧.疤痕子宫再次妊娠二次剖宫产与非疤痕子宫剖宫产的对比研究[J].河北医学,2013,4(6):823-826.
[5] Lian F,Wang Y,Chen W,et al.Uterine artery embolization combined with local methotrexate and systemic methotrexate for treatment of cesarean scar pregnancy with different ultrasonographic pattern[J].Cardio Vascular and Interventional Radiology,2012,35(2):286-291.
[6] 杨桂香.剖宫产后疤痕子宫再次妊娠分娩方式的临床探讨[J].河北医学,2013,11(4):1639-1642.
[7] 汪雪雁,张迅.高龄孕妇的孕前与孕期保健[J].实用妇产科杂志,2013,29(1):7-9.
[8] 唐中兰,张文静,韩钰,等.高龄产妇剖宫产术后切口感染的危险因素及预后分析[J].中华医院感染学杂志,2017,27(22):5240-5242.
[9] 徐瑾,陈淑梅,李国梅.高龄产妇妊娠情况的临床研究[J].当代医学,2017,23(32):80-82.
[10] 张蓉华,陈小海,危秀清,等.547例高龄妇女妊娠情况分析[J].海峡预防医学杂志,2012,7(1):34-35.
[11] 阮焱,张为远.剖宫产的现状及剖宫产率高居不下的原因[J].实用妇产科杂志,2015,31(4):241-243.
[12] 李博雅,杨慧霞.剖宫产后阴道分娩相关问题[J].中国实用妇科与产科杂志,2016,32(8):748-753.
[13] 汤斐,赵云.剖宫产后再次妊娠阴道试产子宫破裂风险防范[J].中国妇幼保健,2018,33(2):457-460.
[14] 潘春煦,杨鹏.4117例二次妊振合并疤痕子宫产妇剖宫产并发症情况分析[J].山东医药,2014,54(2):39-40.
[15] 钟致向,蔡敏.疤痕子宫妊娠孕晚期经阴道分娩的临床结局分析[J].白求恩医学杂志,2017,15(5):591- 592.
[16] 陶艳萍,张步振.疤痕子宫阴道分娩的临床分析[J].昆明医科大学学报,2015,36(12):131-133.
[17] 孙彦飞,方浴娟,张薏女.疤痕子宫再次妊娠二次剖宫产与非疤痕子宫剖宫产的对比研究[J].中国性科学,2015,24(6):93-95.
[18] Bosev D,dimitrov A.Changes in uterine myoma dimentions during pregnancy[J].Akush Ginekol (Sofiia),2007,46(5):3-6.