妊娠期完全性子宫破裂的妊娠结局. (Chinese)

Research Progress on Pregnancy Outcome of Complete Uterine Rupture during Pregnancy. (English)

Complete uterine rupture is a serious obstetrical complication with a low incidence, but once it happens, it will have disastrous consequences for both mother and child, which is one of the important criteria for measuring the quality of obstetrics in a region. The incidence of complete uterine rupture tends to increase due to the increase frequency of cesarean section and the conduction of vaginal birth after cesarean (VBAC), but unscarred uterus rupture carried more catatrophic outcome. The pregnancy outcome of uterine rupture varies in different country and region and in different periods. The complication are more severe in the low-income countries due to poor economic and medical resources，espacially in perinatal outcomes. Most uterine ruptures are not caused by a single high-risk factor, of which scarred uteri following cesarean section is the most common risk factor, meanwhile the other factors including dystocia, lack of prenatal care, inappropriate obstetric interventions. The period from suspected uterine rupture to delivery exceeding 30 minutes significantly increased the risk of perinatal death. Obstetricians need to identify the high-risk factors of uterine rupture early and strengthen the management of high-risk pregnant women. Once a uterine rupture occurs, immediately terminate the pregnancy to ensure the safety of the mother and child. The simultaneous development of social support systems and medical care can better improve the health of mothers and infants. [ABSTRACT FROM AUTHOR]

妊娠期完全性子宫破裂是一种产科严重并发症，其发生率较低，但一旦发生对母儿都会造成灾难性后 果，是衡量一个地区产科质量的重要标准之一。由于剖宫产率的升高及剖宫产后阴道分娩（vaginal birth after cesarean， VBAC）的推广，子宫破裂发生率呈升高趋势，但非瘢痕子宫破裂有更严重的不良结局。子宫破裂的妊娠结局在不同时 期、不同国家及地区各不相同，低收入国家和地区由于经济、医疗等资源匮乏更容易出现严重并发症，尤其在围生儿方 面结局更差。大部分子宫破裂并不是由单一高危因素造成的，产前保健的匮乏、不适当的产科干预及助产等均可能增 加子宫破裂风险。从可疑子宫破裂到胎儿娩出时间超过 30 min 可明显增加围生儿死亡的风险。因此，临床医生需早期 识别子宫破裂的高危因素，加强高危孕产妇妊娠期及产程管理，子宫破裂一旦发生，立即手术终止妊娠，以最大限度地 保证母婴安全。社会支持系统与医疗救治能力的同步发展，能够更好地改善母婴健康。 [ABSTRACT FROM AUTHOR]

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