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子宫破裂在后续分娩中的意义。

The significance of a uterine rupture in subsequent births.

作者信息

Eshkoli Tamar, Weintraub Adi Yehuda, Baron Joel, Sheiner Eyal

机构信息

Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

出版信息

Arch Gynecol Obstet. 2015 Oct;292(4):799-803. doi: 10.1007/s00404-015-3715-0. Epub 2015 Apr 12.

Abstract

OBJECTIVE

To determine whether women with a previous uterine rupture have a higher risk of adverse perinatal outcome in subsequent births.

METHODS

A retrospective study comparing all subsequent singleton cesarean deliveries (CD) of women with a previous uterine rupture, with CD of women with no such history, during the years 1988-2011 was conducted.

RESULTS

Out of 34,601 singleton CD that occurred during the study period, 0.1 % (n = 46) were of women with a previous uterine rupture. Previous uterine rupture was significantly associated with preterm delivery (<37 weeks), low birth weight (<2500 g), cervical tears, and dehiscence of the uterine scar. Pregnancies following a previous uterine rupture were associated with lower Apgar scores at 5 min. However, the perinatal mortality rate did not differ between the two groups. A recurrent uterine rupture occurred in 15.2 % of patients with a previous uterine rupture.

CONCLUSION

Previous uterine rupture is a risk factor for adverse maternal and perinatal outcome and specifically recurrent uterine rupture. Appropriate consultation regarding these risks is needed for patients with a previous uterine rupture.

摘要

目的

确定既往有子宫破裂史的女性在后续分娩中发生不良围产期结局的风险是否更高。

方法

进行一项回顾性研究,比较1988年至2011年间既往有子宫破裂史的女性所有后续单胎剖宫产分娩情况与无此病史女性的剖宫产分娩情况。

结果

在研究期间发生的34601例单胎剖宫产中,0.1%(n = 46)为既往有子宫破裂史的女性。既往子宫破裂与早产(<37周)、低出生体重(<2500g)、宫颈撕裂和子宫瘢痕裂开显著相关。既往有子宫破裂史后的妊娠与5分钟时较低的阿氏评分相关。然而,两组的围产儿死亡率无差异。既往有子宫破裂史的患者中有15.2%发生复发性子宫破裂。

结论

既往子宫破裂是孕产妇和围产期不良结局尤其是复发性子宫破裂的危险因素。对于既往有子宫破裂史的患者,需要就这些风险进行适当的咨询。

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