瘢痕子宫妊娠晚期完全性子宫破裂11例临床分析

摘要

目的 探讨瘢痕子宫妊娠晚期完全性子宫破裂的临床特点.方法 回顾性分析东莞市妇幼保健院2014年8月至2017年9月收治的11例瘢痕子宫妊娠晚期发生的完全性子宫破裂患者的临床资料,归纳、分析其临床特点.结果 11例瘢痕子宫再次妊娠发生完全性子宫破裂患者中,10例均有剖宫产史.7例子宫破裂孕周发生于妊娠37周以后.10例均合并有其他高危因素,余1例无明确相关病史.11例中,4例表现为持续性下腹痛,余7例无典型子宫破裂的临床表现.结论 瘢痕子宫是妊娠晚期完全性子宫破裂的首要原因.瘢痕子宫合并其他高危因素,如经产妇、高龄妊娠、多胎妊娠、胎盘植入、子宫畸形等,发生完全性子宫破裂概率增加.子宫下段瘢痕破裂的孕妇临床表现可能不明显,妊娠期应加强监测.对于可疑子宫破裂的孕妇,应及时处理,改善母儿预后.%Objective To investigate the clinical characteristics of complete uterine rupture in late stage of scar uterus .Methods A retrospective analysis of 11 cases of scarred uterus complete rupture in late stage of scar uterus from August 2014 to September 2017 were carried out in Dongguan Maternal and Child Health Hospital , and the clinical data were summarized and analyzed .Results In these 11 cases of complete uterine rupture after scar pregnancy , there were 10 cases had history of cesarean section, 7 cases occurred frequently after 37 weeks.Ten cases were combined with other risk factors, and only 1 case had no clear history .Of the 11 cases, 4 cases of complete uterine rupture had a characterized manifestation as persistent lower abdominal pain , while the remaining 7 cases had no typical clinical manifestation of uterine rupture .Conclusions Scarred uterus was the most important cause of complete uterine rupture .Scar uterus associated with other high-risk factors, such as postpartum , older pregnancy , multiple pregnancy , placenta implantation , uterine malformation , probability of complete uterine rupture increases .The clinical manifestations of pregnant women with lower uterine scar rupture may not be obvious , and surveillance should be strengthened during pregnancy .Pregnant women with suspected uterine rupture should be treated in time to improve their prognosis .