Explore The Risk Factors Of Cesarean Section Scar Pregnancy

Objective:Through the retrospective analysis of cesarean section number, maternal history,previous cesarean section indications, and the apart from the previous cesarean delivery time interval, such as clinical data, to explore the influence factors of cesarean section scar pregnancy, in order to reduce and prevent the happening of the cesarean section scar pregnancy.Methods:1. Select55 patients diagnosised of cesarean section scar pregnancy in the First and Second Affiliated Hospital of Da Lian Medical University from June 6,2009-November 2014 as CSP group;select the same period patients of scar uterus with intrauterine pregnancy patients 103 cases as control group.Two groups of patients with complete medical history data and always are the lower uterine segment cesarean section.Retrospective analysis the clinical data, the data input Excel, on the age, maternal history of the CSP patients (pregnant numbers, number of cesarean delivery, abortion numbers), the previous cesarean section indications (fetal distress, cephalopelvic disproportion, arrested descent, umbilical cord around the neck, breech, social factors and others), the interval between the previous cesarean delivery, the previous way of lower uterine segment cesarean section uterine incision suture (single suture, double suture) were analyzed, and discussed the relationship between the occurrence of CSP.2. Using SPSS 17.0 statistical software for statistical analysis, counting data using X2 test, measurement data by chi-square test, inspection standards for alpha=0.5.Results:1.The comparison of different ages between CSP group and control group:CSP group of patients with an average age of 32.22+/-3.52 years of age, and control group age 32.39+/-3.21 years, differences in the age distribution of the two groups have no statistical significance (p> 0.05).2. The comparison of maternal history between CSP group and the control group:the differences between two groups of patients with pregnancy numbers, cesarean delivery numbers without statistical significance (p> 0.05);Abortion times of CSP group was obviously higher than that of control group, the difference was statistically significant.3. The comparison of previous cesarean section indications between CSP group and the control group:CSP group for breech indications of cesarean section 12 cases (21.82%), for umbilical cord around the neck12 cases (21.82%), are higher than the control group, comparing differences between the two groups was statistically significant, for social factors are 10 cases (18.18%), higher than the control group, there was no statistically significant difference;cephalopelvic disproportion 6 cases (10.91%), labor stagnation 2 cases (3.64%), lower than the control group, there was no obvious statistical significance difference;Fetal distress in 4 cases (7.27%), lower than the control group, the difference was statistically significant. Arrested descent, fetal distress, cephalopelvic disproportion that cesarean section for these indications are all in labor; Andcesarean delivery for breech, umbilical cord around the neck, and other social factors are all selective cesarean.CSP group selective cesarean section 43 cases (78.18%), significantly higher than the control group, the difference has statistical significance.4. The comparison of time interval from previous cesarean delivery time between CSP group and the control group:this group of data of time interval from the previous cesarean delivery show that the time interval different is statistically significant, CSP group of 24 cases(43.64%) that the interval time is 2 years or less which is higher than the control group, the difference is statistically significant.10 years or more in CSP group is 1 case which is lower than the control group, the differencies statistically significant.2-4 years,4-10 years are similar between the two groups and has no statistical significance.5.The comparison of surgical technique for repairing the uterine incision between CSP group and control group:CSP group than adopting single suture is 20 cases (36.36%), double-stitched 35 cases (63.64%), respectively, compared with control group was not statistically significant.Conclusions:1.When pregnant again elective cesarean section patients were easier to develop CSP than that in labor.2.The number of Pregnancies,cesarean section is not associated with the CSP,while abortion times positively correlated with the occurrence of CSP.3. With the extension of the time interval from the previous cesarean section, CSP incidence tended to decrease.4. The suture way of uterine incision is not the influence factors of CSP.