剖宫产瘢痕部位妊娠相关影响因素分析
Analysis of the related influencing factors on cesarean scar pregnancy
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摘要: 目的:探讨剖宫产瘢痕部位妊娠(CSP)发病的影响因素,为减少和预防CSP的发生提供理论依据。方法:采用回顾性病例对照研究方法,选择60例CSP者为CSP组,选取同期瘢痕子宫宫内正常妊娠者60名为对照组。2组病人病史资料均完整,且既往均为子宫下段剖宫产。分析的相关因素包括年龄、剖宫产次数、人工流产次数、末次剖宫产或人工流产时间、既往剖宫产指征情况等。结果:2组在孕次方面差异无统计学意义(P> 0.05);在人工流产次数、剖宫产次数、末次剖宫产或人工流产时间上,差异有统计学意义(P< 0.01)。CSP组选择性剖宫产49例,明显高于对照组(P<0.01)。多因素非条件logistics回归分析结果显示,剖宫产次数、人工流产次数、末次剖宫产或人工流产时间、既往剖宫产指征对CSP的发生均有影响(P< 0.05~P< 0.01)。结论:选择性剖宫产病人再次妊娠时CSP发生率明显髙于临产后手术者。随距前次剖宫产时间间隔延长,发病有降低趋势。年龄、孕次对CSP发生无明显影响,而人工流产次数、剖宫产次数与CSP的发生呈正相关。Abstract: Objective: To investigate the influencing factors on cesarean scar pregnancy(CSP) for providing the theoretical basis in reducing and preventing the occurrence of CSP.Methods: Sixty patients with CSP were selected using the retrospective case-control study,and set as the CSP group.Sixty normal intrauterine pregnancy patients with uterine scar during the same period were set as the control group.The history data of two groups were complete,and the low cesarean section was implemented in two groups.The age,times of cesarean section and induced abortion,time of the last time of cesarean section and induced abortion,and previous cesarean section indications in two groups were analyzed.Results: The difference of the number of pregnancy between two groups was not statistically significant(P>0.05).The differences of the times of cesarean section and induced abortion,and time of the last time of cesarean section and induced abortion were statistically significant(P<0.01).The number of patients with selective cesarean section(49 cases) was significantly higher than that in control group(P<0.01).Multi-factors non-conditional logistic regression analysis showed that the number of cesarean section and induced abortion,time of the last time of cesarean section and induced abortion,and cesarean section indications affected the occurrence of CSP(P< 0.05 to P< 0.01).Conclusions: The incidence rate of CSP in pregnancy patients with selective cesarean section is significantly higher than that in labor after surgery.With the prolonging of the interval time between two times of cesarean section,the incidence of CSP decreases.The effect of the age and number of pregnancy on the incidence of CSP is not obvious,but the number of induced abortion and cesarean section is positively correlated with the occurrence of CSP.
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Key words:
- scar pregnancy /
- induced abortion /
- cesarean section
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