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目的探讨妊娠期子宫破裂的临床特点及高危因素。方法对中山大学附属第三医院1992年7月至2013年7月妊娠期子宫破裂45例患者的临床资料进行回顾性分析。结果 45例患者中早孕1例,中孕1例,晚孕43例。不完全性子宫破裂35例(其中一次剖宫产史者25例,两次剖宫产史者6例,巨大儿临产1例,产程异常2例,横位1例),子宫破裂10例(其中早、中孕各1例,引产后2例,顺产后1例,死胎3例,梗阻性难产1例,合并酮症酸中毒1例)。结论妊娠期子宫破裂多见于疤痕子宫者,其次梗阻性难产及死胎引产中亦较常见,提示有必要严格控制剖宫产指征,并加强顺产及引产产程监测,对于产程进展异常者需提防子宫破裂可能,以改善母胎预后。
Objective To investigate the clinical features and risk factors of uterine rupture during pregnancy. Methods The clinical data of 45 patients with uterine rupture during pregnancy from July 1992 to July 2013 in the Third Affiliated Hospital of Sun Yat-sen University were analyzed retrospectively. Results 45 cases of early pregnancy in 1 case, 1 case of middle pregnancy, 43 cases of late pregnancy. Incomplete uterine rupture 35 cases (including 25 cases of a history of cesarean section, 6 cases of cesarean section twice, 1 case of huge child labor, 2 cases of abnormal labor, transverse 1 case), 10 cases of uterine rupture One case of early pregnancy, one case of pregnancy, 2 cases after induction of labor, 1 case of cesarean section, 3 cases of stillbirth, obstructive dystocia in 1 case, combined ketoacidosis in 1 case). Conclusion Pregnancy uterine rupture more common in patients with uterine scarring, followed by obstructive dystocia and stillbirth induction is also more common, suggesting the need for strict control of cesarean section indications, and to strengthen the monitoring of labor and induction of labor, labor process abnormalities need to guard against the uterus Rupture may improve maternal fetal prognosis.