|
|
- 2018
子宫切口瘢痕缺陷再次妊娠结局
|
Abstract:
摘要 目的: 探讨子宫切口瘢痕缺陷(PCSD)对再次妊娠结局的影响.方法:再次妊娠的PCSD孕产妇80例为PCSD组,同日分娩的瘢痕子宫非缺陷再次妊娠者169例为NPCSD组,对比两组的临床资料及其新生儿资料,分析PCSD对妊娠结局的影响.结果:PCSD组早产发生率高于NPCSD组;新生儿出生体质量低于NPCSD组; PCSD组子宫下段肌层厚度小于NPCSD组;PCSD组先兆子宫破裂2例,发生率达3.77%,NPCSD组先兆子宫破裂1例,发生率0.59%.结论:PCSD患者再次妊娠早产、子宫破裂、低体质量儿的风险增加,超声形态学检测虽不能有效的评估风险,但憩室体积越大子宫下段肌层功能可能越差.
| [1] | ZHANG Y. A comparative study of transvaginal repair and laparoscopic repair in the management of patients with previous Cesarean scar defect[J].J Minim Invasive Gynecol,2016,23(4):535-541. |
| [2] | SCHEPKER N, GARCIA-ROCHA G J, VON VERSEN-HOYNCK F, et al. Clinical diagnosis and therapy of uterine scar defects after caesarean section in non-pregnant women[J].Arch Gynecol Obstet, 2015,291(6):1417-1423. |
| [3] | BARANOV A, SALVESEN K A, VIKHAREVA O. Assessment of Cesarean hysterotomy scar before pregnancy and at 11-14 weeks of gestation: a prospective cohort study[J].Ultrasound Obstet Gynecol, 2017,50(1):105-109. |
| [4] | ALLORNUVOR G F, XUE M, ZHU X, et al. The definition, aetiology, presentation, diagnosis and management of previous caesarean scar defects[J].J Obstet Gynaecol, 2013,33(8):759-763. |
| [5] | CHEN Y, HAN P, WANG Y J, et al. Risk factors for incomplete healing of the uterine incision after cesarean section[J].Arch Gynecol Obstet, 2017,296(2): 355-361. |
| [6] | TANIMURA S, FUNAMOTO H, HOSONO T J, et al. New diagnostic criteria and operative strategy for cesarean scar syndrome: Endoscopic repair for secondary infertility caused by cesarean scar defect[J]. Obstet Gynaecol Res,2015,41(9):1363-1369. |
| [7] | ZHANG S M, ZHOU D, PENG P. Diagnosis and treatment of previous Cesarean scar defect[J]. Chinese Journal of Practical Gynaecology and Obstetrics, 2015,2(31):174-176. |
| [8] | 谢幸,苟文丽.妇产科学.第8版[M].北京:人民卫生出版社, 2013: 218-219. |
| [9] | QUEENAN J T. How to stop the relentless rise in cesarean deliveries[J]. Obstet Gynecol, 2011, 118(2 Pt 1): 199-200. |
| [10] | 张世妹,周丹,彭萍.剖宫产子宫瘢痕憩室诊断和治疗进展.中国实用妇科与产科杂志,2015,2(31):174-176. |
| [11] | KEMP M W. Preterm birth, intrauterine infection, and fetal inflammation[J]. Front Immunol, 2014. 5:574. |
| [12] | SUAREZ S E, HALADJIAN M C, BRADBURY M. Laparoscopic isthmocele repair with hysteroscopic assistance[J].J Minim Invasive Gynecol, 2017, 24(7):S18. |
| [13] | OVALLE A, KAKARIEKA E, RENCORET G, et al. Risk factors for preterm deliveries in a public hospital[J]. Rev Med Chil, 2012, 140(1): 19-29. |
| [14] | LUMBIGANON P, LAOPAIBOON M, GULMEZOGLU A M, et al. Method of delivery and pregnancy outcome in Asia: the WHO global survey on maternal and perinatal health 2007-08[J]. Lancet, 2010, 375(9713): 490-499. |
| [15] | LI Z.Clinical analysis of 13cases subsequent pregnancy with previous cesarean scar defect post-operative repairs[D]. Zhejiang University.2015. |
| [16] | JASTROW N, CHAILLET N, ROBERGE S, et al. Sonographic lower uterine segment thickness and risk of uterine scar defect: a systematic review[J]. J Obstet Gynaecol Can, 2010, 32(4): 321-327. |
| [17] | 肖曼,郝传伟,贺小薇,等.超声检查在疤痕子宫经阴道分娩中的临床价值[J].吉林医学, 2013, 34(12): 2301-2302. |
| [18] | XIAO M,HAO C,HE X,et al.Clinical value of ultrasonic examination in scar uterus by vaginal delivery[J]. Jilin Medical Journal, 2013, 34(12): 2301-2302. |
| [19] | UPPAL T, LANZARONE V, MONGELLI M. Sonographically detected caesarean section scar defects and menstrual irregularity[J].J Obstet Gynaecol, 2011,31(5):413-416. |
| [20] | KOK N, WIERSMA I C, OPMEER B C, et al. Sonographic measurement of lower uterine segment thickness to predict uterine rupture during a trial of labor in women with previous Cesarean section: a meta-analysis[J]. Ultrasound Obstet Gynecol, 2013, 42(2): 132-139. |
| [21] | VAN DER V L, LIMPERG T, VEERSEMA S, et al. Niches after cesarean section in a population seeking hysteroscopic sterilization[J].Eur J Obstet Gynecol Reprod Biol, 2017,214(214):104-108. |
| [22] | XIE X, GOU W L. Obstetrics and gynecology. Eighth Edition[M]. Beijing: People′s Medical Publishing House, 2013, 218-219. |
| [23] | 李智.剖宫产子宫切口瘢痕缺陷修复术后再妊娠13例临床分析[D].浙江大学, 2015. |
| [24] | UHARCEK P, BRESTANSKY A, RAVINGER J, et al. Sonographic assessment of lower uterine segment thickness at term in women with previous cesarean delivery[J]. Arch Gynecol Obstet, 2015, 292(3): 609-612. |
