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我院1963～1989年间因产科急症行子宫切除75例,发生率为0.14％,其中剖宫产并子宫切除57例,占剖宫产术的0.61％;阴道分娩后子宫切除18例,占阴道分娩的0.01％。75例子宫切除指征:胎盘因素居第1位,共40例,其中胎盘植入17例,胎盘早剥14例,前置胎盘9例。子宫破裂居第2位,共25例,其中子宫疤痕破裂11例。子宫肌瘤居第3位,共4例。75例中全宫切除15例,次全切除60例。本组存活新生儿30例,宫内死胎、死产及新生儿死亡45例,因产儿死亡率600‰,无产妇死亡。作者认为:人工流产及剖宫产是发生前置胎盘及胎盘植入的因素,要降低产科子宫切除的发生率,必须做好计划生育工作,正确掌握剖宫产指征,提高剖宫产技术,尽量减少胎盘早剥、子宫破裂的发生。
In our hospital from 1963 to 1989 due to obstetric emergency hysterectomy in 75 cases, the incidence was 0.14%, of which 57 cases of cesarean section and hysterectomy, accounting for 0.61% of cesarean section; vaginal delivery after hysterectomy in 18 cases, accounting for the vagina 0.01% of delivery. 75 cases of hysterectomy indications: placenta factor ranked No. 1, a total of 40 cases, of which 17 cases of placenta accreta, 14 cases of placental abruption, placenta previa in 9 cases. Uterine rupture ranked No. 2, a total of 25 cases, including uterine rupture in 11 cases. Uterine fibroids in the first 3, a total of 4 cases. 75 cases of hysterectomy in 15 cases, subtotal resection in 60 cases. The group of surviving 30 newborns, intrauterine fetal death, stillbirths and neonatal deaths in 45 cases, due to birth fatality rate of 600 ‰, no maternal deaths. The authors believe that: abortion and cesarean section is placenta previa and placenta accreta factors, to reduce the incidence of obstetric hysterectomy, we must do a good job in family planning work, correctly grasp the indications of cesarean section and improve cesarean section , Try to reduce the occurrence of placental abruption, uterine rupture.