孕晚期子宮下段全層厚度檢測對瘢痕子宮再次妊娠分娩方式選擇的影響(1)
[摘要] 目的 探討孕晚期子宮下段全層厚度檢測對瘢痕子宮再次妊娠分娩方式選擇的指導(dǎo)意義。 方法 選擇本院2012年2月～2013年10月接收的瘢痕子宮產(chǎn)婦200例。按孕晚期子宮下段全層厚度分成兩組，各100例，研究組子宮下段全層厚度≥3 mm，對照組子宮下段全層厚度<3 mm，對兩組產(chǎn)婦的產(chǎn)后情況進(jìn)行比較。 結(jié)果 研究組產(chǎn)婦的自然分娩率明顯高于對照組，再次剖宮產(chǎn)中研究組術(shù)中及術(shù)后出血量、血紅蛋白、不全子宮破裂、子宮切口愈合及子宮收縮乏力等均明顯優(yōu)于對照組，差異有統(tǒng)計(jì)學(xué)意義(P<0.05)；兩組新生兒窒息率比較，差異無統(tǒng)計(jì)學(xué)意義(P>0.05)。 結(jié)論 孕晚期子宮下段全層厚度檢測對瘢痕子宮再次妊娠分娩方式的選擇具有重要指導(dǎo)意義，可降低母嬰并發(fā)癥的發(fā)生率，值得推廣及應(yīng)用。
[關(guān)鍵詞] 孕晚期；子宮下段全層厚度；瘢痕子宮；再次妊娠；分娩方式
[中圖分類號(hào)] R714 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-4721(2015)05(b)-0084-03
Impact of lower uterine segment full thickness detection of third trimester for delivery mode selection of uterine scar pregnancy again
ZHONG Xiao-qiong LIU Mei-xia
Department of Gynecology and Obstetrics，Center Hospital of Longgang District in Shenzhen City，Shenzhen 518116，China
[Abstract] Objective To investigate the guidance significance of lower uterine segment full thickness detection of the third trimester for delivery mode selection of uterine scar pregnancy again. Methods 200 cases of the maternal uterine scar in our hospital from February 2012 to October 2013 were selected，and were divided into two groups according to third trimester full thickness of the lower uterine segment，100 patients in each group，study group full thickness of the lower uterine segment thickness were≥3 mm，control group full thickness of the lower uterine segment thickness were<3 mm，the postpartum between two groups of puerpera was compared respectively. Results The natural birth rate of study group were significantly higher than that in control group，the intraoperative and postoperative bleeding，hemoglobin，incomplete uterine rupture，uterine incision healing and poor uterine inertia of study group puerpera was significantly better than that of control group，with significant difference(P<0.05)；The rate of neonatal asphyxia betwwen two groups’ data was no significant difference(P>0.05). Conclusion The Lower uterine segment full thickness detection of third trimester has an important guiding significance for delivery mode selection of uterine scar pregnancy again，which can reduce the incidence of maternal complications，and it′s worthy of promotion and application.
[Key words] Third trimester；Whole thickness of the lower uterine segment；Uterine scar；Subsequent pregnancy；Mode of delivery options
瘢痕子宮是由于行子宮肌瘤剔除術(shù)、剖宮產(chǎn)術(shù)等導(dǎo)致子宮留存了瘢痕[1]。剖宮產(chǎn)率逐年上升，瘢痕子宮再次妊娠也隨之增加，帶來的子宮破裂風(fēng)險(xiǎn)與母嬰的并發(fā)癥也相應(yīng)提高[2-3]，瘢痕子宮常被作為手術(shù)指征選擇再次剖宮產(chǎn)，使有試產(chǎn)條件的產(chǎn)婦未能陰道試產(chǎn)分娩，瘢痕子宮再次妊娠分娩方式的選擇已是產(chǎn)科臨床關(guān)注的熱點(diǎn)問題[4]。本文探討孕晚期宮下段全層厚度檢測對瘢痕子宮再次妊娠分娩方式選擇的指導(dǎo)意義。
1 資料與方法 (鐘小瓊 劉美霞)
[關(guān)鍵詞] 孕晚期；子宮下段全層厚度；瘢痕子宮；再次妊娠；分娩方式
[中圖分類號(hào)] R714 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-4721(2015)05(b)-0084-03
Impact of lower uterine segment full thickness detection of third trimester for delivery mode selection of uterine scar pregnancy again
ZHONG Xiao-qiong LIU Mei-xia
Department of Gynecology and Obstetrics，Center Hospital of Longgang District in Shenzhen City，Shenzhen 518116，China
[Abstract] Objective To investigate the guidance significance of lower uterine segment full thickness detection of the third trimester for delivery mode selection of uterine scar pregnancy again. Methods 200 cases of the maternal uterine scar in our hospital from February 2012 to October 2013 were selected，and were divided into two groups according to third trimester full thickness of the lower uterine segment，100 patients in each group，study group full thickness of the lower uterine segment thickness were≥3 mm，control group full thickness of the lower uterine segment thickness were<3 mm，the postpartum between two groups of puerpera was compared respectively. Results The natural birth rate of study group were significantly higher than that in control group，the intraoperative and postoperative bleeding，hemoglobin，incomplete uterine rupture，uterine incision healing and poor uterine inertia of study group puerpera was significantly better than that of control group，with significant difference(P<0.05)；The rate of neonatal asphyxia betwwen two groups’ data was no significant difference(P>0.05). Conclusion The Lower uterine segment full thickness detection of third trimester has an important guiding significance for delivery mode selection of uterine scar pregnancy again，which can reduce the incidence of maternal complications，and it′s worthy of promotion and application.
[Key words] Third trimester；Whole thickness of the lower uterine segment；Uterine scar；Subsequent pregnancy；Mode of delivery options
瘢痕子宮是由于行子宮肌瘤剔除術(shù)、剖宮產(chǎn)術(shù)等導(dǎo)致子宮留存了瘢痕[1]。剖宮產(chǎn)率逐年上升，瘢痕子宮再次妊娠也隨之增加，帶來的子宮破裂風(fēng)險(xiǎn)與母嬰的并發(fā)癥也相應(yīng)提高[2-3]，瘢痕子宮常被作為手術(shù)指征選擇再次剖宮產(chǎn)，使有試產(chǎn)條件的產(chǎn)婦未能陰道試產(chǎn)分娩，瘢痕子宮再次妊娠分娩方式的選擇已是產(chǎn)科臨床關(guān)注的熱點(diǎn)問題[4]。本文探討孕晚期宮下段全層厚度檢測對瘢痕子宮再次妊娠分娩方式選擇的指導(dǎo)意義。
1 資料與方法 (鐘小瓊 劉美霞)