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目的探讨瘢痕子宫再次足月妊娠的最佳分娩方式。方法回顾性分析203例瘢痕子宫再次妊娠孕妇的临床资料。结果选择阴道试产156例,试产成功115例,余41例因产科指征中转剖宫产,试产成功率73.7%,子宫不全破裂发生率0.6%,选择行剖宫产者47例,其中B超检查提示子宫下段切口为Ⅱ级或Ⅲ级瘢痕21例均采取剖宫产术,7例术中发现子宫下段肌层缺如,如仅留绒毛膜、蜕膜层、浆膜层,子宫不全破裂发生率14.9%。结论 B超检查对瘢痕子宫再次妊娠分娩方式选择有重要意义;具备阴道试产条件者在充分术前准备下可行阴道分娩。
Objective To investigate the best modes of delivery for full term pregnancy of scar uterus. Methods Retrospective analysis of 203 pregnant women with uterine scar pregnancy again clinical data. Results 156 cases of vaginal trial and 115 cases of successful trial were selected. The success rate of trial production was 73.7% and the rate of uterine rupture was 0.6%. Forty-seven cases of cesarean section were selected, Which B-ultrasound examination prompted the lower uterine incision grade Ⅱ or Ⅲ grade cicales 21 cases were taken cesarean section, 7 cases of intraoperative findings of the lower uterine muscle absence, such as only the left chorionic, decidual, serosa, The incidence of uterine rupture 14.9%. Conclusion B-ultrasound on scar pregnancy uterine pregnancy again choice of mode of delivery is of great significance; with vaginal trial production conditions feasible preoperative vaginal delivery.