Analysis Of Influencing Factors Of Cesarean Scar Pregnancy

Cesarean section uterine scar pregnancy refers to has a history of cesareansection for pregnant women, the embryo implantation in the lower uterine segmentcesarean section incision scar place[1]，the majority of domestic literature, the loweruterine segment caesarean scar pregnancy, ectopic a special type of pregnancy,patients often due to complicated with placenta accreta, uterine rupture, hemorrhagetreated with hysterectomy and loss of fertility, or even loss of life. In recent years,with the clinical application of cesarean section and vaginal ultrasound technology isincreasing year by year, the incidence and the detection rate of CSP was increased, aserious threat to women of childbearing age, reproductive health and life safety. Thispaper aims to explore the factors that influence the pathogenesis of CSP, and providea theoretical basis for its prevention and reducing the occurrence of CSP.ObjectiveThrough the retrospective analysis of CSP in patients with previous cesareansection uterine incision suture, pregnancy history, previous cesarean section clinicaldata of preoperative abnormal conditions, to investigate influence factors on thepathogenesis of CSP, to provide a theoretical basis for reducing the occurrence andprevention of CSP. Materials and Methods1. Choose53patients with cesarean scar pregnancy between January2003andJuly2003in the Third Affiliated Hospital of Zhengzhou University for CSP group,select the same scar uterus and intrauterine pregnancy patients95cases as controlgroup.The previous cesarean section of CSP group and the control group of patientswere operated in the hospital, and the operation mode are lower uterine cesareansection.2. Analyzed retrospectively the clinical data of53patients with cesarean scarpregnancy, including age of the patients, history of maternal (pregnant time, numberof induced abortion, cesarean delivery times), previous cesarean section uterineincision suture method (continuous slurry muscle all single layer suture andcontinuous suture muscle layer, serous embedding double stitching), previouscesarean section clinical data of preoperative abnormal conditions(premature ruptureof membranes,placental abruption, human placenta decollement, breech cesareansection), etal.And analyzed the relationship between the factors and and theincidence o of CSP.3. SPSS17.0software package was used with clinical sorted data entry toestablish database and statistical analysis, using chi-square test, α＝0.05acted aslevel of significance.Results1Comparison between CSP group and control group in different ageCSP patients focused on31~40years old, but compared with the control group,there is no statistical difference of two groups in age distribution (P>0.05).2Comparison of pregnancy,cesarean section and artificial abortioncases between CSP group and control groupDifferences of CSP in pregnancy group of53patients have no statisticalsignificance (P>0.05); Abortion≥2times in38cases (71.7%),30cases of cesareansection≥2times (56.6%), was significantly higher than that of control group, the difference was statistically significant (P<0.05).3Comparison of previous cesarean section uterine incision suturebetween CSP group and the controlCSP group of53cases with single layer suture methods30patients (56.6%),higher than that of control group, the difference had statistical significance (P <0.05).4Comparison between CSP group and control group with previouscesarean section surgical anomaliesIn53patients with CSP,25cases of premature rupture of membranes (47.2%),breech cesarean section in20cases (37.7%), were significantly higher than those incontrol group, the difference was statistically significant (P <0.05);7cases ofplacental abruption (13.2%), the ratio is lower than the control group, but thedifference was not statistically significant (P>0.05); artificial fetal exploitation fromoperation in8cases (15.1%), significantly lower than the control group, thedifference was statistically significant (P <0.05). The CSP group of prematurerupture of fetal membranes with4cases of placental abruption, and breech cesareansection in2cases of premature rupture of membranes, artificial separation ofplacenta with breech cesarean section in1cases.5Comparison of the time interval from the previous cesarean sectionbetween CSP group and the controlCSP group and the control group in the time interval from the previous cesareansection distribution there was statistical difference (P <0.05), which from theprevious cesarean section≤5years in37cases (69.8%),2=4.646, P=0.031,obviously higher than the control group;2cases≥16years (3.8%),2=4.241, P=0.039, the ratio is lower than the control group, the differences were statisticallysignificant (P <0.05). Conclusion1. The uterine incision suture method of previous cesarean section was one ofinfluence factors of the CSP.2. Repeated abortion history, repeated cesarean section history, prematurerupture of membranes, breech cesarean section and the distance from the previouscesarean section are the influencing factors of CSP...