既往有子宫破裂史患者的妊娠结局

Pregnancy outcome in patients with previous uterine rupture.

作者信息

Usta Ihab M, Hamdi Mohamad A, Musa Antoine A Abu, Nassar Anwar H

机构信息

Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.

出版信息

Acta Obstet Gynecol Scand. 2007;86(2):172-6. doi: 10.1080/00016340601089768.

DOI:10.1080/00016340601089768

PMID:17364280

Abstract

BACKGROUND

To review the outcome of subsequent pregnancies in conservatively managed cases of uterine rupture.

METHODS

Charts of patients with full thickness uterine rupture in the past 25 years were reviewed and information on subsequent pregnancies was extracted from maternal and neonatal charts.

RESULTS

Thirty-seven patients with uterine rupture were identified; the uterus was scarred in 62.2%. Ruptures were repaired in 26 (70.3%). Twelve patients subsequently conceived (24 pregnancies), with recurrence in 8/24 (33.3%) pregnancies or 5/12 (41.7%) patients. Patients with recurrence had a shorter median interval from previous rupture (2 versus 5 years), a higher incidence of previous longitudinal ruptures (60.0% versus 0.0%), and the median gestational age at the preceding rupture was lower without reaching statistical significance (34 versus 38 weeks; p = 0.209).

CONCLUSIONS

Longitudinal ruptures and short intervals between rupture and subsequent pregnancy predispose to recurrence of uterine rupture.

摘要

背景

回顾子宫破裂保守治疗病例的后续妊娠结局。

方法

回顾过去25年全层子宫破裂患者的病历，并从母婴病历中提取后续妊娠的信息。

结果

共确定37例子宫破裂患者；62.2%的患者子宫有瘢痕。26例（70.3%）进行了破裂修复。12例患者随后怀孕（24次妊娠），其中8/24（33.3%）次妊娠或5/12（41.7%）例患者复发。复发患者距上次破裂的中位间隔时间较短（2年对5年），既往纵向破裂的发生率较高（60.0%对0.0%），上次破裂时的中位孕周较低，但未达到统计学意义（34周对38周；p = 0.209）。