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目的分析影响剖宫产术后再次剖宫产的因素。方法对99例剖宫产术后再次妊娠孕妇资料进行回顾性分析。结果前次剖宫产指征仍然存在(骨盆狭窄)21例;距前次剖宫产不足2年者18例;前次为古典式子宫切口或前次为子宫下段横切口但愈合不良5例;过期妊娠1例;胎位异常7例;羊水过少3例;胎膜早破6例;妊娠期糖尿病6例;妊娠期高血压疾病5例;27例产妇不愿接受阴道试产,主动要求再次剖宫产。99例孕妇在接受再次剖宫产术出现的并发症:仰卧位低血压综合征、出血过多、临近器官脏器损伤、羊水栓塞、产褥期感染、子宫切口愈合不良。经正确及时采取措施,孕妇均安全分娩、无子宫切除情况。结论对二次剖宫产的指征详细确认,做好并发症预防和处理工作,采取合适的腹壁切口和切口缝合方法,有助改善产妇结局,提升产妇生活质量。
Objective To analyze the factors influencing cesarean section after cesarean section. Methods Retrospective analysis of 99 pregnant women after cesarean section. Results The previous cesarean section indications still exist (pelvic stenosis) in 21 cases; from the previous cesarean section in less than 2 years in 18 cases; the last for the classical uterine incision or the previous lower uterine transverse incision but poor healing in 5 cases ; 1 case of obsolete pregnancy; 7 cases of abnormal fetal position; 3 cases of oligohydramnios; 6 cases of premature rupture of membranes; 6 cases of gestational diabetes mellitus; 5 cases of hypertensive disorder during pregnancy; 27 maternal unwilling to accept vaginal trial production, Cesarean section again. 99 cases of pregnant women in the second cesarean section occurred complications: supine hypotensive syndrome, excessive bleeding, adjacent organ damage, amniotic fluid embolism, puerperal infection, uterine incision healing. After the correct and timely measures, pregnant women are safe delivery, no hysterectomy. Conclusion The indication of secondary cesarean section is confirmed in detail, prevention and treatment of complications are well done, proper abdominal incision and incision suture method can be used to improve the maternal outcome and improve the quality of life of pregnant women.