Risk Factors Forre-Pregnancy Women With Scared Uterus:A Meta-Analysis

Objectives:In this article,we used meta-analysis to explore the effect of scar uterus on second pregnancy and second cesarean section.We compared the risk of first-trimester pregnancy in patients with non-scarred uterine uterus with those of patients with scarred uterus and re-occlusion,to Provide objective data for the clinical development of effective prevention and treatment measures to reduce cesarean section rate.Methods:Through the computer literature search domestic Chinese literature database: China National Knowledge Infrastructure(CNKI),Wanfang database,Weipu network and Longy uanperiodicine network to collect domestic scar uterus and non-scarred uterus re-pregnancy risk factors of comparative analysis and study and references,from Postpartum hemorrhage,ruptured uterus,placenta previa,and placental implants were analyzed.The literature was published during the period 2006-2016 and language restrictions are limited to Chinese.Strict screening of collected data.Rev Man5.3 analysis software was used.The first step is to test the heterogeneity.When the heterogeneity does not exist in the test results,the model is described by a fixed effect model.When the test results have heterogeneity,the random effect model is used to express the description.At the same time,the analysis of the data to conduct a quantitative comprehensive summary.This metaanalysis uses the odds ratio(OR)and its 95% confidence interval(95% CI).Results:The final screening was strictly based on the criteria of the included literature and the exclusion criteria.Finally,16 case-control studies that met the criteria were included.The number of cases of scar uterus was 5878,and the number of non-scarred uterus in the control group was 6538.The combined OR and 95% confidence interval for postpartum hemorrhage,placenta previa,ruptured uterus,and placenta were OR=4.64,95% CI(3.79-5.67),OR=3.27,95% CI(2.34-4.57),OR=7.55,95% CI(3.99-14.28),OR=6.34,95% CI(3.32-12.10).Conclusion:When patients with scars and uterus re-pregnant and when undergoing cesarean section surgery,the resulting complications were significantly higher in patients with postpartum hemorrhage,placenta previa,ruptured uterus,and placenta implant than in non-scarred uterus.It is recommended to develop effective treatment measures in clinic to reduce the non-indicated cesarean section rate.