摘要
目的观察人工流产类型对再次妊娠产妇妊娠期并发症及母儿结局的影响。方法选取2016年10月至2022年10月于南京大学医学院附属苏州医院分娩的有人工流产史的初产妇580例,将药物流产史产妇纳入药物流产组(n=300),手术流产史产妇纳入手术流产组(n=280),另外选取同期无流产史的初产妇280例作为对照组。比较3组产妇妊娠期并发症发生情况、产妇分娩结局及新生儿评分。结果药物流产组与手术流产组的先兆流产率高于对照组,手术流产组的胎盘前置、胎膜早破、产后出血、胎盘粘连及胎盘残留发生率高于药物流产组与对照组(P<0.05),同时药物流产组妊娠期并发症总发生率低于手术流产组(P<0.05)。3组产妇分娩结局中的剖宫产以及死胎率之间的差异无统计学意义(P>0.05),药物流产组与手术流产组产妇早产比例高于对照组(P<0.05)。3组新生儿的体重、身高及1 min Apgar评分之间的差异无统计学意义(P>0.05),药物流产组与手术流产组5 min Apgar评分低于对照组(P<0.05),药物流产组与手术流产组之间的差异无统计学意义(P>0.05)。药物流产组流产1次与2次及以上产妇的胎膜早破、产后出血、胎盘粘连及胎盘残留的发生率之间的差异无统计学意义(P>0.05),同时各并发症发生率均低于手术流产组(P<0.05)。手术流产组流产次数在2次及以上的产期并发症发生率均高于手术流产1次产妇(P<0.05)。结论与手术流产相比,选择药物流产方式能降低初产妇的妊娠期并发症发生率,但无流产史的妊娠更有益于良好的母儿结局,做好避孕、避免意外妊娠与人工流产是保证孕产妇母儿良好结局的关键。
Objective To observe the effect of types of artificial abortion history on gestational complications and maternal-infant outcomes in re-pregnant women.MethodsA total of 580 primiparas women with induced abortion history who gave birth in the Afiliated Suzhou Hospital of Nanjing University Medical School between October 2016 and October 2022 were selected.Among them,women with medical abortion history and those with surgical abortion history were included in the medical abortion group(n=300)and the surgical abortion group(n=280),respectively.At the same time,280 primiparas without abortion history were selected as the control group.The incidence of gestational complications,matermnal delivery outcomes and neonatal scores in the three groups were compared.ResultsThe incidence rates of threatened abortion in the medical abortion group and the surgical abortion group were higher than that in the control group.The incidence of placental previa,premature rupture of membranes,postpartum bleeding,placenta stickiness and placenta residue in the surgical abortion group were higher than those in the medical abortion group and the control group(P<0.05).The total incidence of gestational complications in the medical abortion group was lower than that in the surgical abortion group(P<0.05).There was no significant difference in cesarean section or stillbirth rate among the three groups(P>0.05).The rates of premature delivery in the medical abortion group and the surgical abortion group were higher than that in the control group(P<0.05).There was no significant difference in neonatal weight,height andI min Apgar score among the three groups(P>0.05).5 min Apgar scores of the medical abortion group and the surgical abortion group were lower than that of the control group(P<0.05),without significant difference between the medical abortion group and the surgical abortion group(P>0.05).In the medical abortion group,there was no significant difference in the incidence rates of premature rupture of membranes,postpartum hemorrhage,placental adhesion and placenta residue between women with once abortion and those with abortion over twice(P>0.05).The incidence rates of complications were lower than those in the surgical abortion group(P<0.05).In the surgical abortion group,the incidence rates of perinatal complications in women with abortion over twice were higher than those in women with once abortion(P<0.05).Conclusion Compared with surgical abortion,medical abortion can reduce the incidence rates of gestational complications in primiparas.Pregnancy without abortion history can achieve better maternal-infant outcomes.Therefore,contraception to avoid accidental pregnancy and artificial abortion is the key to ensure better maternal-infant outcomes.
作者
徐爱芳
董芮
Xu Aifang;Dong Rui(Department of Obstetrics and Gynecology,the Affliated Suzhou Hospital of Nanjing University Medical School,Suzhou Jiangsu 215000,P.R.China)
出处
《中国计划生育和妇产科》
2023年第11期45-48,共4页
Chinese Journal of Family Planning & Gynecotokology
关键词
药物流产史
手术流产史
再次妊娠产妇
妊娠期并发症
母儿结局
medical abortion history
surgical abortion history
re-pregnant woman
gestational complication
maternal-infant outcomes
