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目的分析并探讨瘢痕子宫再次剖宫产与非瘢痕子宫剖宫产妊娠结局的差异。方法 2014年1月至2016年1月莱芜市人民医院产科收治的瘢痕子宫再次剖宫产产妇100名作为观察组,选取同期收治的非瘢痕子宫剖宫产产妇100名作为对照组。观察并对比两组产妇妊娠结局,包括子宫破裂情况,胎盘情况以及手术情况。结果观察组先兆子宫破裂发生率为17.00%,不完全子宫破裂11.00%,完全子宫破裂1.00%。对照组先兆子宫破裂发生率为2.00%,不完全子宫破裂1.00%,无完全子宫破裂。观察组先兆子宫破裂和不完全子宫破裂发生率明显高于对照组(P<0.05)。观察组胎盘植入发生率为13.00%,前置胎盘发生率为12.00%,胎盘粘连发生率为12.00%。对照组胎盘植入发生率为2.00%,前置胎盘发生率为1.00%,胎盘粘连发生率为1.00%。观察组胎盘植入、前置胎盘以及胎盘粘连发生率明显高于对照组(P<0.05)。观察组手术时间、术中出血量明显高于对照组(P<0.05)。结论瘢痕子宫再次剖宫产与非瘢痕子宫剖宫产相比,危险性高,并发症发生率高,初产妇应慎重选择分娩方式。
Objective To analyze and discuss the differences of pregnancy outcomes between cesarean section with non-scarred cesarean section and scarred uterus. Methods From January 2014 to January 2016, 100 maternal cesarean section patients who were admitted to the obstetrics department of Laiwu People’s Hospital were selected as the observation group. 100 maternal non-scarring cesarean section patients were selected as the control group. Observe and compare the two groups of maternal pregnancy outcomes, including uterine rupture, placental conditions and surgical conditions. Results The incidence of threatened uterine rupture in observation group was 17.00%, incomplete uterine rupture was 11.00% and complete uterine rupture was 1.00%. In the control group, the incidence of threatened uterine rupture was 2.00%, incomplete uterine rupture was 1.00%, and there was no complete uterine rupture. The incidence of threatened uterine rupture and incomplete uterine rupture in the observation group was significantly higher than that in the control group (P <0.05). The incidence of placenta accreta in observation group was 13.00%, the incidence of placenta previa was 12.00%, and the incidence of placental adhesion was 12.00%. In the control group, the incidence of placenta accreta was 2.00%, the incidence of placenta previa was 1.00%, and the incidence of placental adhesion was 1.00%. The incidence of placenta accreta, placenta previa and placenta accreta in the observation group was significantly higher than that of the control group (P <0.05). The operation time and intraoperative blood loss in the observation group were significantly higher than those in the control group (P <0.05). Conclusion Compared with non-scar cesarean section, cesarean section in scar-shaped uterus is more dangerous and has a higher complication rate.