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目的 探讨子宫破裂发生的原因、诊断处理及对母儿的危害。方法 对2002年7月至2003年7月 马里共和国锡加索大区医院98例子宫破裂患者的病因及诊治、母儿预后作回顾性分析。结果 子宫破裂原因中 阻塞性难产53%,药物引产不当24.5%,疤痕子宫14.3%,不恰当的助产方式9.2%,其中产程中诊断86例,产后 诊断12例,全部患者行手术治疗,其中子宫切除2例,子宫修补术96例,产妇死亡3例,围生儿死亡92例。结论 子宫破裂是妊娠晚期和分娩时的严重并发症,严重威胁母婴生命,应引起全体产科工作者的高度重视。其中药物 引产不当和不恰当的助产方式可通过提高医生业务水平来避免。阻塞性难产中胎位不正可通过加强孕期保健来 纠正,而其余原因所致子宫破裂要早诊断早治疗以利母儿预后。
Objective To investigate the causes of uterine rupture, diagnosis and treatment of maternal and child harm. Methods A retrospective analysis was performed on the etiology, diagnosis and treatment of maternal uterine rupture and the prognosis of maternal and child in 98 cases of patients with uterine rupture in the Hospital of the Western Saiga, Republic of Mali from July 2002 to July 2003. Results The causes of uterine rupture were obstructive dystocia 53%, drug misdiagnosis 24.5%, scar uterus 14.3%, inappropriate mode of midwifery 9.2%, of which 86 cases were diagnosed during labor and 12 cases were diagnosed postpartum. All the patients underwent surgical treatment, 2 cases of hysterectomy, 96 cases of uterine repair, maternal death in 3 cases, 92 cases of perinatal death. Conclusions Uterine rupture is a serious complication in late pregnancy and childbirth. Serious threat to maternal and infant life should be paid great attention to by all obstetricians. Among them, improper induction of drugs and improper midwifery can be avoided by improving the doctor’s professional level. Obstructive dystocia in the fetal position can be corrected by strengthening the health care during pregnancy, and other causes of uterine rupture to early diagnosis and early treatment to benefit the prognosis of the mother.