早期妊娠稽留流产患者术后转归的临床观察

Clinical observation of postoperative outcome of missed abortion in early pregnancy

摘要:

目的： 观察一系列保护女性生育能力的干预措施应用在早期妊娠稽留流产患者手术治疗后的效果及在此类人群中获益情况。方法： 对293例早期妊娠稽留流产的手术治疗患者给予围手术期规范处理及全程贯彻流产后关爱（post-abortion care，PAC）服务，观察术中出血、子宫穿孔等并发症发生情况，随访其术后恢复、再生育及意外妊娠情况。结果： 通过规范围手术期操作，手术治疗术中并发症发生率极低，临床效果肯定，术后有生育意愿者术后6个月内再次妊娠占比为20.22%，1年内再次妊娠占比为46.45%。通过围手术期优质PAC服务，术后患者避孕意识明显提高，1年内无生育计划者意外妊娠率为1.82%。结论： 围手术期规范手术操作、提供优质PAC服务，降低了术中并发症的发生率，提高了早期妊娠稽留流产患者再次妊娠率，减少了意外妊娠，保护了女性生育能力。

Abstract:

Objective: To observe the effects of a series of interventions to protect female fertility after surgical treatment of missed abortion in early pregnancy and the benefits in this population. Methods: A total of 293 cases of missed abortion in early pregnancy were treated with standardized perioperative treatment and post-abortion care (PAC) services the complications such as bleeding and uterine perforation were observed, and the postoperative recovery, rebirth and unintended pregnancy were followed up. Results: By standardized perioperative operation, the incidence of intraoperative complications was very low, and the clinical effect was positive. Among those having willness of fertility desire, 20.22% of them had the fertility intention to have a second pregnancy within 6 months after operation, and 46.45% had a second pregnancy within 1 year after operation. With the high quality PAC service in perioperative period, the contraceptive awareness of postoperative patients was significantly improved, and the unintended pregnancy rate was 1.82% in patients without family planning within one year. Conclusion: The standardized operation and high quality PAC service in perioperative period can reduce the incidence of intraoperative complications, improve the recurrence rate of missed abortion in early pregnancy, reduce unintended pregnancy, and protect female fertility.