Yin Yin, Limei Huang, Nuo Xu, Huagang Ma, Chaoyan Yuan
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引用次数: 0
Abstract
Objective: This study aimed to analyze the outcome of postoperative re-pregnancies in patients with a cesarean scar pregnancy (CSP) and investigate the factors influencing the occurrence of recurrent cesarean section scar pregnancy (RCSP).
Methods: A retrospective analysis was performed on the clinical data of 105 patients with CSP who had undergone surgical treatment and were admitted to the Minda Hospital affiliated with Hubei University for Nationalities, Henan Provincial People's Hospital, Linyi People's Hospital, and Weifang People's Hospital from January 2015 to May 2021. The reproductive outcomes of these patients were monitored, and the factors influencing the occurrence of RCSP were analyzed.
Results: In this study, it was found that the reproductive outcomes of patients with CSP after surgery included ectopic pregnancy, normal intrauterine pregnancy, RCSP, and abortion. The postoperative re-pregnancy rate was 51.72% (105/203), and the postoperative RCSP rate was 13.33% (14/105). The number of cesarean sections (OR = 2.004, 95% CI: 1.412-22.579, p < 0.001) was identified as an independent risk factor for the occurrence of RCSP, and the intraoperative removal of the uterine scar (OR = 0.045, 95% CI: 0.005-190.400, p = 0.002) was determined as an independent protective factor for the occurrence of RCSP.
Conclusion: For patients with residual reproductive requirements after CSP surgery, the removal of uterine scar tissue during the operation can be contemplated. Subsequent postoperative re-pregnancy demands close surveillance and follow-up during gestation, with appropriate termination of pregnancy when warranted. For patients without reproductive needs after surgery, contraception is recommended to prevent the occurrence of RCSP.
目的：本研究旨在分析剖宫产瘢痕妊娠（CSP）患者术后再妊娠的结局，探讨影响剖宫产瘢痕妊娠（RCSP）发生的因素。方法：回顾性分析2015年1月至2021年5月在湖北民族学院附属人民大医院、河南省人民医院、临沂市人民医院、潍坊市人民医院行手术治疗的105例CSP患者的临床资料。对这些患者的生殖结局进行监测，并分析影响RCSP发生的因素。结果：本研究发现，CSP患者术后生殖结局包括异位妊娠、正常宫内妊娠、RCSP和流产。术后再妊娠率为51.72%(105/203)，术后RCSP率为13.33%（14/105）。剖宫产次数（OR = 2.004,95% CI: 1.412-22.579, p p = 0.002）被确定为RCSP发生的独立保护因素。结论：对于CSP术后仍有生殖需求的患者，术中可考虑切除子宫瘢痕组织。术后再次妊娠需要在妊娠期间密切监测和随访，必要时适当终止妊娠。对于术后无生殖需求的患者，建议采取避孕措施，防止RCSP的发生。
期刊介绍：
Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate
- the use of patient-reported outcomes under real world conditions
- the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines
- the scientific bases for guidelines and decisions from regulatory authorities
- access to medicinal products and medical devices worldwide
- addressing the grand health challenges around the world
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