剖宫产术后阴道分娩子宫开裂和破裂的风险因素。

Q3 Medicine
Hana Hakim, Mohamed Derbel, Hajer Mtibaa, Basma Akrout, Khaled Trigui, Fatma Chaker, Fatma Khanfir, Kais Chaabane
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引用次数: 0

摘要

导言:目的:确定子宫开裂和破裂的风险因素:这是一项前瞻性、分析性和描述性观察研究,在一家三级护理产科医院进行。我们纳入了所有曾进行过一次剖腹产手术并正在进行试产的产妇。我们对子宫疤痕的质量进行了评估,并在产后进行了评价:我们纳入了 300 名曾接受过一次剖腹产手术并进行试产的产妇。50.7%的病例试产成功(阴道分娩)。经产后评估,79%的病例子宫瘢痕质量良好。我们发现有 7 例子宫破裂(占 2.3%),56 例开裂(占 18.6%)。胎次、前次剖腹产的情况(计划或紧急)和孕间期与分娩结果有显著关系(分别为P=0.004、P=0.001和P=0.135)。子宫破裂或开裂的发生与巨大儿(新生儿体重超过4000克)无明显关系(P=0.135):了解子宫开裂和破裂的风险因素可使产科医生正确评估情况,从而做出正确的决定,避免新生儿和产妇并发症的发生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk factors for uterine dehiscence and rupture in case of vaginal birth after cesarean section.

Introduction: Vaginal delivery after caesarean section (VBAC) is recommended, but the rising rate of uterine rupture calls into question the safety of this practice.

Aim: To identify risk factors for uterine dehiscence and rupture.

Methods: This was a prospective, analytical and descriptive observational study, carried out in a tertiary care maternity. We included all parturients with one previous caesarean section undergoing trial of labor. We assessed the quality of the uterine scar which was evaluated after delivery.

Results: We included 300 patients with one previous caesarean section undergoing trial of labor. The trial of labor was successful (vaginal delivery) in 50.7% of cases. The uterine scar, assessed after delivery, was of good quality in 79% of cases. We noted 7 cases of uterine rupture, i.e. 2.3% of cases, and dehiscence in 56 patients, i.e. 18.6% of cases. Parity, conditions of previous caesarean section (programmed or emergency) and interpregnancy interval were significantly related to the labor outcome (p=0.004, p=0.001 and p=0.135 respectively). The occurrence of rupture or dehiscence was not significantly related to macrosomia, defined as a neonatal weight greater than 4000g (p=0.135).

Conclusion: Knowing the risk factors for uterine dehiscence and rupture would enable the obstetrician to properly assess the situation in order to make the correct decision and avoid neonatal and maternal complications.

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来源期刊
Tunisie Medicale
Tunisie Medicale Medicine-Medicine (all)
CiteScore
1.00
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72
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