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目的探讨无疤痕子宫破裂的相关因素、诊断治疗及预防措施,减少孕产妇及围产儿死亡。方法收集1994年～2005年我院收治的18例分娩期无疤痕子宫破裂病例,对其临床资料进行回顾性分析。结果梗阻性难产13例,产前不当使用宫缩剂10例,分娩时手术创伤3例;死胎1例,死产15例,新生儿存活2例,围产儿死亡率88.89%(16/18);6例行子宫次全切除术,2例行子宫全切术,9例行子宫破裂修补术,1例并发输尿管损伤行吻合术;产妇死亡1例。结论加强围产期保健,严密观察产程,及时处理难产,严格掌握宫缩剂的使用,严格各种阴道手术指征,提高基层产科质量,是预防子宫破裂的关键措施。
Objective To investigate the related factors of uterine rupture without scar, diagnosis, treatment and preventive measures to reduce maternal and perinatal deaths. Methods 18 cases of uterine rupture without childbirth in our hospital from 1994 to 2005 were collected, and their clinical data were retrospectively analyzed. Results Obstructive dystocia in 13 cases, prenatal uterine contraceptive improper use in 10 cases, 3 cases of surgical trauma during labor; 1 stillbirth, 15 stillbirths, 2 newborns surviving, perinatal mortality rate of 88.89% (16/18) ; 6 cases of subtotal hysterectomy, 2 cases of hysterectomy, 9 cases of uterine rupture repair, 1 case of ureteral injury anastomosis; maternal death in 1 case. Conclusions Strengthen the perinatal care, closely observe the labor process, timely treatment of dystocia, strictly control the use of uterine contractions, strict indications of vaginal surgery, and improve the quality of primary obstetrics, is the key measure to prevent uterine rupture.