疤痕子宫的孕期管理20137

1、1会计学疤痕子宫的孕期管理疤痕子宫的孕期管理201371阴道分娩38.46%2社会因素13.21%3疤痕子宫8.19%4胎儿窘迫7.02%5巨大儿6.35%6羊水过少5.69%7臀位5.18%8脐带绕颈3.01%9头盆不称2.34%10高龄初产2.01%11双胎妊娠2.01%12胆汁淤积1.67%13前置胎盘1.51%14其它1.51%15骨盆狭窄0.84%16胎盘早剥0.50%17引产失败0.50%阴道分娩48.00%CDMR16.67%头盆不称7.67%ICP6.00%胎儿窘迫4.67%巨大儿3.33%臀位3.33%瘢痕子宫1.67%引产失败1.67%羊水过少1.33%HDCP1.00%前

2、置胎盘1.00%高龄初产1.00%骨盆狭窄1.00%合并卵巢肿瘤0.67%FGR0.67%脐带脱垂0.33%剖宫产阴道分娩PPH（估算）8.15%4.35%HB下降20g/L10.16%14.03%HB下降10g/L25.82%27.15%术前HB105g/L28.03%23.08%剖宫产出血量阴道分娩x381.23235.96s193.76136.77min23590max18501080Wang CB，Chiu WW，Lee CY，et a1Cesarean scar defect：correlation between Cesarean section number，defect siz

3、e，clinical symptoms and uterine position. Ultrasound Obstet Gynecol，2009(34)：85-89刘小艳,杨合荣,王 江,常 青.早孕期终止瘢痕子宫患者意外妊娠的临床分析J.重庆医学,2012,41(8).第三军医大学西南医院妇产科.剖宫产切口瘢痕部位妊娠的研究进展张国美综述 糜若然 杜 雪审校邹丽颖，范玲.J.中华妇产科杂志,2010,45(1).剖宫产史（次）12345胎盘植入率（%） 0.2 0.3 0.6 2.1 2.3American College of Obstetricians and Gynecologists

4、:postpartum hemorrhage 2006(04)剖宫产(243)疤痕子宫(49)x341.8399.8s103.9146.8min235250max1120930Abstracts of the American College of Obstetricians and Gynecologists 52nd Annual Clinical MeetingMay 1-5，2004，Philadelphia，PennsylvaniaUSA JObstetGynecol 2004，103 (4Supp1)：4S一143S.有利因素不利因素孕妇年龄40岁40岁阴道分娩史有没有前次剖宫产史

5、1次2次前次剖宫产指征胎儿窘迫或胎位异常 产程停滞两次分娩间隔时间19月19月子宫颈扩张4cm1cm子宫颈消退75%25%胎头位置低于S-1未衔接胎龄40周40周预测新生儿体重4000g4000g使用药物诱导宫缩没有有剖宫产后再次阴道分娩陈敦金，何玉甜Ejub Basic, Vesna Basic-Cetkovic, Hadzo Kozaric,et al.Ultrasound Evaluation of Uterine Scar After Cesarean SectionJ, ACTA INFORM MED. 2012 , 20(3): 149-153.Abdel Baset F.Moha

6、mmed;Diaa A.Al-Moghazi Ultrasonographic evaluation of lower uterine segmentthickness in pregnant women with previous cesarean section 2010(03)杨悦,黄醒华.剖宫产后再次妊娠产科处理方式的探究J.首都医科大学学报,2009,30(1).KweeA，BotsMI，VisserGH，et a1Obstetricmanagementand outcome of pregnancy in women with a history of cesarean section in the NetherlandsJEur J Obstet Gynecol Reprod Biol，2007，132(2)：171-176陈诚,常青.瘢痕子宫剖宫产围手术期处理J.中国计划生育和妇产科2012,4.American College of Obstetricians and Gynecologists:postpartum hemorrhage 2006(04)有利因素不利因素孕妇年龄40岁40岁阴道分娩史有没有前次剖宫产史1次2