摘要
目的探讨子宫破裂的原因、诊治及预防措施。方法回顾性分析2001年~2012年本院收治的16例子宫破裂病例。结果 16例子宫破裂病例均发生在妊娠晚期和分娩期,其中按破裂程度分,不完全性子宫破裂5例,完全性子宫破裂11例;破裂原因有子宫手术史7例(其中前次剖宫产5例,肌瘤剔除史2例),梗阻性难产4例,宫缩剂应用不当3例,穿透性胎盘植入导致破裂2例;手术方式8例行子宫修补术,6例行子宫次全切除术,2例行子宫全切术;新生儿结局存活9例,死胎6例,死产1例,围产儿死亡率43.75%。结论子宫破裂与子宫手术史、梗阻性难产、宫缩剂应用不当、胎盘植入等因素密切相关,应加强围产保健,重视对高危孕产妇的管理,严格掌握剖宫产指征,慎重对待未生育妇女子宫肌瘤剔除术,合理应用宫缩剂,严密观察产程,促进自然分娩,降低子宫破裂发生率,从而改善母婴结局。
Objective To explore the reason, treatment and prevention of uterine rupture. Methods A retrospective analysis of our hospital from 2001 to 2012 in 15 cases of uterine rupture. Results All 16 cases occurred in the late pregnancy and labor. Classify them by the degree of rupture, we have 5 incomplete ruptures and 11 complete ruptures. For the reason, 7 cases got history of uterine surgery（including 5 cases of previous cesarean delivery and 2 cases of previous myomectomy）, 4 cases got obstructive dystocia, 3 cases got improper use of contraction agents and 2 cases of penetrating placenta implantation. For the methods of surgery, we got 8 cases of uterine neoplasty, 6 cases of subtotal hysterectomy and 2 cases of total hysterectomy. For perinatal outcome, we got 9 cases of neonatal survival, 6 cases of fetal death, and 1 case of stillbirth-a perinatal children＇s mortality of 43.75%. Conclusion Uterine rupture is closely related to factors as history of uterine surgery, obstructive dystocia, improper use of contraction agents and placenta implantation. We should strengthen perinatal health care, attach great importance to the management of high-risk pregnant women, strictly control indication of cesarean section, treat carefully with myomectomy for barren women, take rational use of contraction agents, make an intimate observation of labor, promote natural delivery and reduce the incidence of uterine rupture. Therefore the outcome of mother and fetus will be better.
作者
王军会
WANG Jun-hui(Lu Shi People＇s Hospital,Sanmenxia,Henan,472200,China)
出处
《临床研究》
2018年第10期15-16,共2页
Clinical Research
关键词
子宫破裂
疤痕子宫
剖宫产
宫缩剂
uterine rupture
scarred uterus
cesarean delivery
contraction agent
