Feto-Maternal Medicine, Department of Obstetrics and Gynecology, King Fahad University Hospital, University of Dammam, Saudi Arabia.
Curr Opin Obstet Gynecol. 2013 Jun;25(3):214-9. doi: 10.1097/GCO.0b013e32835fab11.
This review will address fertility and pregnancy outcome in women with history of uterine rupture.
Increasing rates of primary Cesarean delivery and vaginal birth after one or more Cesarean sections will lead to higher rates of uterine rupture. Recent advances in reproductive medicine, open fetal surgery and gynecological surgery may also play a role in increasing uterine rupture rate. The implementation of the American College of Obstetricians and Gynecologists and Royal College of Obstetricians and Gynecologists guidelines on birth after Cesarean section will decrease the Cesarean section rate but may transiently increase the rate of uterine rupture. The maternal and perinatal risks of multiple Cesarean birth are much higher than those of uterine rupture. Women with prior uterine rupture are fertile. They have higher risk of recurrent uterine rupture.
Every obstetrician is bound to face the challenge of uterine rupture or women with prior uterine rupture. Those women should have a favorable maternal and perinatal outcome when managed in a tertiary center.
本文将讨论有子宫破裂史的女性的生育和妊娠结局。
随着首次剖宫产率和一次或多次剖宫产术后阴道分娩率的增加，子宫破裂的发生率也会升高。生殖医学、开放式胎儿手术和妇科手术的进步也可能导致子宫破裂率的增加。美国妇产科医师学会和皇家妇产科医师学院关于剖宫产术后分娩的指南的实施将降低剖宫产率，但可能会暂时增加子宫破裂的发生率。多次剖宫产的母婴风险远高于子宫破裂。有子宫破裂史的女性仍具有生育能力，且再次发生子宫破裂的风险较高。
每位产科医生都必然会面临子宫破裂或有子宫破裂史的女性的挑战。这些女性在三级中心得到管理时，应该有良好的母婴结局。
