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刮宫术会影响未来的妊娠结局吗?

Does dilation and curettage affect future pregnancy outcomes?

作者信息

Lohmann-Bigelow Jennifer, Longo Sherri A, Jiang Xiaozhang, Robichaux Alfred G

出版信息

Ochsner J. 2007 Winter;7(4):173-6.

Abstract

OBJECTIVE

The purpose of this study was to determine if dilation and curettage has an effect on future pregnancy outcome.

METHODS

Retrospective review of the electronic medical records of all patients who underwent D&C between January 1, 2002, and December 31, 2006, was performed. Patients who had one or more subsequent pregnancies were selected and evaluated for pregnancy outcome. Frequency and incidence of subsequent pregnancy complications were determined by Chi square and Fisher's exact tests and compared to reported statistics.

RESULTS

The incidence of postpartum hemorrhage was significantly higher than previously reported averages (p < 0.0004). We found no difference in the incidence of preterm delivery, preeclampsia, placental abruption, malpresentation, cervical incompetence, first trimester bleeding, and miscarriage when compared with previously reported data. Pregnancy outcomes among patients with a history of cervical dilation and those without were not significantly different.

CONCLUSION

The current study suggests that dilation and curettage may predispose to postpartum hemorrhage. It is important to consider the effects of surgical management for miscarriage on future pregnancy outcomes.

摘要

目的

本研究的目的是确定刮宫术是否会对未来的妊娠结局产生影响。

方法

对2002年1月1日至2006年12月31日期间接受刮宫术的所有患者的电子病历进行回顾性审查。选择有一次或多次后续妊娠的患者,并对其妊娠结局进行评估。通过卡方检验和费舍尔精确检验确定后续妊娠并发症的频率和发生率,并与报告的统计数据进行比较。

结果

产后出血的发生率显著高于先前报告的平均值(p < 0.0004)。与先前报告的数据相比,我们发现早产、先兆子痫、胎盘早剥、胎位异常、宫颈机能不全、孕早期出血和流产的发生率没有差异。有宫颈扩张史的患者和没有宫颈扩张史的患者的妊娠结局没有显著差异。

结论

当前研究表明,刮宫术可能易引发产后出血。考虑流产手术管理对未来妊娠结局的影响很重要。

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Obstetric outcomes after surgical abortion at > or = 20 weeks' gestation.孕20周及以上手术流产后的产科结局。
Am J Obstet Gynecol. 2005 Sep;193(3 Pt 2):1161-4. doi: 10.1016/j.ajog.2005.05.078.

本文引用的文献

1
Risk factors for cervical insufficiency after term delivery.足月分娩后宫颈机能不全的危险因素。
Am J Obstet Gynecol. 2006 Sep;195(3):787-91. doi: 10.1016/j.ajog.2006.06.069.
2
Expectant care versus surgical treatment for miscarriage.
Cochrane Database Syst Rev. 2006 Apr 19(2):CD003518. doi: 10.1002/14651858.CD003518.pub2.
3
Management of spontaneous abortion.自然流产的管理
Am Fam Physician. 2005 Oct 1;72(7):1243-50.
9

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