[1]李灵玲,秦娟,肖准*.妊娠晚期瘢痕子宫引产的安全性探讨[J].中国计划生育和妇产科,2018,(6):84-87.
　LI Ling-ling,QIN Juan,XIAO Zhun*.Investigation on the safety of induced labor in women of third-trimester pregnancy with scar uterus[J].Chinese Journal of Family Planning & Gynecotokology,2018,(6):84-87.
点击复制

妊娠晚期瘢痕子宫引产的安全性探讨
分享到：

《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2018年6期
页码:
84-87
栏目:
论著与临床
出版日期:
2018-06-25

文章信息/Info

Title:
Investigation on the safety of induced labor in women of third-trimester pregnancy with scar uterus
作者:
李灵玲1; 秦娟1; 肖准2*
1.610045四川成都，四川省妇幼保健院产科； 2. 610041四川成都，四川大学华西第二医院妇产科
Author(s):
LI Ling-ling1; QIN Juan1; XIAO Zhun2*
1.Department of Obstetrics,Sichuan Provincial Women and Children’s Hospital,Chengdu Sichuan 610045；2.Department of Obstetrics and Gynecology,West China Second University Hospital,Chengdu Sichuan 610041,P.R.China
关键词:
瘢痕子宫; 引产; 自然临产; 剖宫产
Keywords:
scar uterus;  induced labor;  natural labor; cesarean section
分类号:
R 7142
摘要:
目的探讨晚孕期瘢痕子宫引产的可行性及安全性。方法回顾性分析2015年7月至2016年10月在四川省妇幼保健院住院的瘢痕子宫妊娠患者113例的病历资料，其中有引产指征实施引产的37例为观察组，自然临产的76例为对照组。比较两组产妇经阴道试产成功率、中转剖宫产率、产程时长、阴道出血量及并发症发生情况。结果观察组试产成功率（6216 ％）较对照组（8684 ％）低，差异有统计学意义（P<005）；两组先兆子宫破裂及子宫破裂发生率、产后出血量、产后出血发生率、产褥感染、切口感染率、新生儿窒息发生率比较差异无统计学意义（P＞005）。结论符合条件的瘢痕子宫妊娠孕妇，如有产科引产指征，在严密监测下进行引产和阴道试产是安全的，但其引产的成功率较自然临产者低，须充分评估后选择。
Abstract:
ObjectiveTo investigate the feasibility and safety of induced labor in women of third-trimester pregnancy with scar uterus. MethodsFrom July 2015 to October 2016, the clinical data of 113 pregnant women in Sichuan Provincial Women and Children’s Hospital with scar uterus were analyzed retrospectively. 37 women with indication of induced labor were in the observation group and 76 women of natural onset were in the control group. The rate of successful vaginal labor and conversion to cesarean section, labor duration，the volume of blood loss and maternal and infant complications were compared. ResultsThe rate of successful vaginal labor in observation and control group was 6216 % and 8684 % respectively. The success rate in the observation group was lower than that of the control group, and the difference was statistically significant (P<005). There were no significant differences in the incidence of uterine rupture and uterine rupture, postpartum hemorrhage, postpartum hemorrhage, puerperal infection, incision infection, and neonatal asphyxia in the two groups(P>005). ConclusionIt is safe for pregnant women with scar uterus to have induced labor if the indication is justified, but the success rate of induced labor is lower, so it should be strictly evaluated and selected.

参考文献/References:

［1］潘朴芬，吕晓芳．剖宫产后再次妊娠76例阴道试产分析 ［J］．中国误诊学杂志，2008，8（16）：3924-3925． ［2］陈敦金，何玉甜．剖宫产后再次阴道分娩 ［J］．中国实用妇科与产科杂志，2012，28（2）：103-104． ［3］中华医学会妇产科学分会产科学组．剖宫产术后再次妊娠阴道分娩管理的专家共识（2016） ［J］．中华妇产科杂志，2016，51（8）：561-564． ［4］谢幸，苟文丽．妇产科学 ［M］．第8版．北京：人民卫生出版社，2013：8． ［5］申恒春．剖宫产术后瘢痕子宫再次妊娠93例分娩方式探讨 ［J］．实用妇产科杂志，2013，29（3）：234-236． ［6］LYDON-ROCHELLE M T, CAHILL A G, SPONG C Y Birth after previous cesarean delivery: short-term maternal outcomes ［J］. Seminars in Perinatology, 2010, 34(4): 249-257. ［7］SILVER R M. Delivery after previous cesarean: long-term maternal outcomes ［J］. Seminars in Perinatology, 2010, 34(4): 258-266. ［8］郭小燕，周莉．首次剖宫产术后再次妊娠阴道分娩的概述 ［J］．中日友好医院学报，2013，27（3）：177-179． ［9］LANDON M B, HAUTH J C, LEVENO K J, et al. Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery ［J］. New England Journal of Medicine, 2004, 351(25): 2581-2589. ［10］KIRAN T S, CHUI Y-k, BETHEL J, et al. Is gestational age an independent variable affecting uterine scar rupture rates? ［J］. European Journal of Obstetrics & Gynecology and Reproductive Biology, 2006, 126(1): 68-71. ［11］LYDON-ROCHELLE M, HOLT V L, EASTERLING T R, et al. Risk of uterine rupture during labor among women with a prior cesarean delivery ［J］. The New England Journal of Medicine, 2001, 345(1): 3-8. ［12］BUJOLD E, BLACKWELL S C, GAUTHIER R J. Cervical ripening with transcervical Foley catheter and the risk of uterine rupture ［J］. Obstetrics and Gynecology, 2004, 103(1): 18-23. ［13］BULLETIN A P. 115:vaginal birth after previous cesarean delivery ［J］. Obstetrics and Gynecology, 2010, 116(2 Pt 1): 450-463. ［14］MACONES G A, PEIPERT J, NELSON D B, et al. Maternal complications with vaginal birth after cesarean delivery: a multicenter study ［J］. American Journal of Obstetrics and Gynecology, 2005, 193(5): 1656-1662. ［15］CATLING-PAULL C, JOHNSTON R, RYAN C, et al. Clinical interventions that increase the uptake and success of vaginal birth after caesarean section: a systematic review ［J］. Journal of Advanced Nursing, 2011, 67(8): 1646-1661. ［16］李云秀，柏智，龙大坚，等．剖宫产术后再次妊娠足月引产与自然临产比较 ［J］．中华临床医师杂志(电子版)，2015，3（6）：1047-1049． ［17］中华医学会妇产科学分会产科学组．妊娠晚期促子宫颈成熟与引产指南(2014) ［J］．中华妇产科杂志，2014，49（12）：881-885．

相似文献/References:

[1]胡佳菊,薛梅,宋琼,等.米非司酮配伍米索前列醇用于孕中期死胎引产的临床分析[J].中国计划生育和妇产科,2010,(01):0.
[2]姚纪萍.依沙吖啶联合米非司酮、米索前列醇在中期妊娠引产中的临床应用[J].中国计划生育和妇产科,2010,(01):0.
[3]唐国梅.米索前列醇联合依沙吖啶终止瘢痕子宫中期妊娠的临床观察[J].中国计划生育和妇产科,2010,(02):0.
[4]拉毛切忠.米非司酮配伍依沙吖啶终止中期妊娠临床观察[J].中国计划生育和妇产科,2010,(04):0.
[5]王星.一次性宫腔组织吸引管用于瘢痕子宫人工流产术临床观察[J].中国计划生育和妇产科,2011,(02):0.
　WANG Xing Family Planning Service Station of Fuyang city,Fuyang Anhui 000,P.R.China.[J].Chinese Journal of Family Planning & Gynecotokology,2011,(6):0.
[6]邹敏,刘正飞.492例瘢痕子宫妊娠分娩结局临床分析[J].中国计划生育和妇产科,2011,(05):0.
　ZOU Min,LIU Zheng-fei.[J].Chinese Journal of Family Planning & Gynecotokology,2011,(6):0.
[7]王涛,陈红.间苯三酚联合催产素在足月孕引产中应用的临床观察[J].中国计划生育和妇产科,2011,(06):0.
　WANG Tao,CHEN Hong.[J].Chinese Journal of Family Planning & Gynecotokology,2011,(6):0.
[8]范光升.中期妊娠引产方法的临床应用及评价[J].中国计划生育和妇产科,2013,(02):0.
　FAN Guang-sheng,[J].Chinese Journal of Family Planning & Gynecotokology,2013,(6):0.
[9]闫少甫.瘢痕子宫妊娠重复剖宫产并发症的对比分析[J].中国计划生育和妇产科,2013,(03):0.
　YAN Shao - fu.[J].Chinese Journal of Family Planning & Gynecotokology,2013,(6):0.
[10]胡红梅,赵敏.子宫颈扩张双球囊在足月妊娠引产的临床疗效观察[J].中国计划生育和妇产科,2013,(04):0.
　HU Hong-mei,ZHAO Min.[J].Chinese Journal of Family Planning & Gynecotokology,2013,(6):0.
[11]韦春杏*,李小芬.水囊引产术在瘢痕子宫妊娠中晚期引产的应用研究[J].中国计划生育和妇产科,2018,(１):60.
　WEI Chun-xing*,LI Xiao-fen.Application research of inducing abortion by water bag in the middle and late stage of uterine scar pregnancy[J].Chinese Journal of Family Planning & Gynecotokology,2018,(6):60.
[12]董兰,范翠芳*,孙艳美,等.米非司酮联合利凡诺用于瘢痕子宫中期妊娠引产的系统评价[J].中国计划生育和妇产科,2018,(12):16.
　DONG Lan,FAN Cui-fang*,SUN Yan-mei,et al.Evaluation of mifepristone combined with rivanol for induced labor in scars uterus midtrimester pregnancy[J].Chinese Journal of Family Planning & Gynecotokology,2018,(6):16.
[13]何佳佳.宫腔球囊填塞在瘢痕子宫伴胎盘植入孕妇中孕期引产的应用效果[J].中国计划生育和妇产科,2019,(5):29.
　HE Jia-jia.Application effect of uterine cavity balloon tamponade in the induction of labor during mid pregnancy in women with scar uterus pregnancy and placenta implantation[J].Chinese Journal of Family Planning & Gynecotokology,2019,(6):29.
[14]何健华*,莫务琼,陈燕婷,等.宫颈扩张球囊和地诺前列酮在宫颈低Bishop评分瘢痕子宫孕产妇促宫颈成熟中的作用比较[J].中国计划生育和妇产科,2019,(11):73.
　HE Jian-hua*,MO Wu-qiong,CHEN Yan-ting,et al.The promoting cervical ripening comparison of cervical dilation balloon and dinoprostone in low Bishop score uterus maternal[J].Chinese Journal of Family Planning & Gynecotokology,2019,(6):73.

更新日期/Last Update: 2018-06-25