| Objective:In order to provide theory basis for reducing and preventing the CSP(cesarean scar pregnancy),the clinical data,such as patients age 、 gestation history 、 cesarean section 、cesarean section uterine incision suture method were analyzed,the influence factors on the pathogenesis of CSP were discussed.Methods:In this study,130 patients with CSP in our hospital between January 2015 and December 2018 were selected as experimental group(CSP group);at the same time,130 cases with normal pregnancy after the cesarean section were selected as control group.The clinical data of both the experimental group and control group,including age,cesarean section condition(cesarean section reasons,vaginal delivery process and cesarean section week),gestation history(abortion times and cesarean delivery times),cesarean section uterine incision suture method,distance the previous cesarean section time and pregnancy complications were retrospective analyzed,respectively.Results:1、The comparison of gestation history between CSP group and control group.The proportion of multiple cesarean sections(37.69% VS 10%)and multiple induced abortion(33.85% VS 19.23%)in the CSP group was higher than that in the control group,and the difference between the two groups was significant(P < 0.05).2、The comparison of cesarean section reasons between CSP group and control group.There was no significant difference in fetal distress,oligohydramnios and other factors between the two groups(P >0.05).Cesarean sections in the CSP group indicated by “fetal macrosomia,hypertensive disorder complicating pregnancy,breech presentation”were significantly higher than those in the control group(P <0.05).Cesarean section in the control group indicated by "abnormal labor process" was significantly higher than that in the CSP group,with statistically significant difference(P < 0.05).3、The comparison of vaginal delivery process between CSP group and control group.The proportions of the two groups in different operation times were different,and the difference was statistically significant(P<0.05).There were statistically significant differences between cesarean section with uterine dilatation < 6cm and elective cesarean section,cesarean section with uterine dilatation ≥ 6cm(P < 0.016).There was no statistically significant difference between elective cesarean section and cesarean section with uterine dilatation ≥6cm(P > 0.016).4、The comparison of cesarean section week between CSP group and control group.There were 30 cases(23.08%)of premature cesarean section in the CSP group,higher than 12 cases(9.23%)of the control group,the difference between the two groups is statistically significant(P<0.05).5、The comparison of cesarean section uterine incision suture method between CSP group and control ground.In the CSP group,79cases(60.77%)were sutured by monolayer suture,which was higher than that in the control group 33cases(25.38%).The difference between the two groups was statistically significant(P < 0.05).6、The comparison of time interval from the previous caesarean section between CSP group and control group.The proportion of patients in the two groups at different intervals time was different,and the difference was statistically significant(P < 0.05).The difference was statistically significant(P < 0.016)between 2 to 5 years postoperatively and 2 years postoperatively,and more than 5 years postoperatively(P <0.016).However,there was no statistically significant difference between gestation within 2 years after surgery and gestation over 5 years after surgery(P > 0.016).7、The comparison of premature rupture of membranes,pregnancy complications between CSP group and control group.There were statistically significant differences between the two groups in basic diseases(anemia,hypoproteinemia,diabetes mellitus)and premature rupture of membranes(P < 0.05).8、The comparison of age between CSP group and control group.The cesarean section age was statistically significant between the two groups(P<0.05).The onset age is no significant difference between the two groups(P>0.05).9、Multiple logistic regression analysis Multiple regression analysis showed that cesarean section times,induced abortion imes,elective cesarean section,premature cesarean section、uterine incision suture method,distance the previous cesarean section time are the related factors of CSP.Conclusion:1、Multiple cesarean section and induced abortion are risk factors for CSP.2、The interval from the previous cesarean section was less than 2 years or more than 5years is risk fanctor for CSP.3、Elective cesarean section,cesarean section with uterine dilatation ≥ 6cm and premature cesarean section are risk factors for CSP.4、Single-layer suture method of uterine incision is risk factor for CSP. |
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