探讨瘢痕子宫再次剖宫产手术时机对母儿的影响及预防措施。方法将疤痕子宫再次妊娠进入产程后再次剖宫产的85例产妇作为观察组，将疤痕子宫再次妊娠未进入产程择期剖宫产的76例产妇作为对照组。对2组产妇的手术时间、出血量、手术开始至胎儿娩出时间、术后并发症以及新生儿出生后的状况进行比较分析。结果观察组手术时间、手术开始至胎儿娩出时间、胎儿娩出至术毕时间、剖宫产总时间及术中出血量均显著高于对照组，P<0．05。观察组术后血红蛋白水平较对照组低。观察组术中大出血，术后并发症以及新生儿窒息例数明显高于对照组，P<0．05。结论瘢痕子宫再次分娩手术时机的选择一般常选在预产期前1～2周，通过 B 超了解胎盘的成熟度、胎头大小及子宫切口处的厚薄，若出现胎膜早破，胎儿窘迫或巨大儿分娩前兆等其他剖宫产指征时，可随时手术，结束妊娠。加强孕期保健，术前 B 超预测瘢痕子宫切口厚度，在严密检测下鼓励瘢痕子宫再次妊娠者阴道试产，可降低瘢痕子宫患者再次妊娠的母婴围产期并发症。
Scar uterus cutting production operation time influence on female son again
objective to explore the scar uterine cesarean section surgery timing effect on female son again and preventive measures. Line method wil once again in 85 cases of cesarean section scar uterus as observation group, maternal line wil be in the same period in 76 cases of cesarean section scar uterus women as control group. On two groups of maternal operation time, blood loss, postoperative complications, and comparative analysis of the status of after birth. Results the observation group operation to the fetus, fetal childbirth time to postoperative time, cesarean section when asked about the total amount of bleeding was significantly higher than that in the control group, P<0.05. The patients in the observation group than in the control group and low hemoglobin level. Hemorrhage group operation, postoperative complications and neonatal asphyxia were significantly higher than those in the control group, P<0.05. Conclusion uterine scar again delivery operation timing generaly choose before expected date of childbirth 1 ~ 2 weeks, understanding through B ultrasound placenta maturity, fetal head size and the thickness of uterine incision, if appear premature rupture of membranes, and fetal distress or macrosomia delivery precursor and other indications of cesarean section, may at any time operation at the end of pregnancy. Strengthening prenatal care, preoperative B ultrasound prediction of scar uterine incision thickness, in the strict detection encourage scar uterine pregnancy vaginal trial production, can reduce the uterine scar pregnancy patients with perinatal complications.
scar uteruscesarean sectioneffect of mother and infant
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