疤痕的子宫背后,剖宫产率高吗?
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尤其是近年来,我国剖宫产率飙升,比例高达33%,有的医院甚至达到80-90%。 我国有相当多的孕妇为了选择顺产时机选择剖宫产,害怕疼痛,剖宫产的商业保险待遇高于自然分娩,担心自然分娩导致阴道松弛,其实自然分娩和剖宫产都各有优点,同时也伴随着一定的风险。
怀有疤痕子宫的第二个或第三个孩子有什么风险?
- 1、疤痕妊娠。即在妊娠早期,孕囊不是植入正常宫腔内,而是植入上次剖宫产的子宫瘢痕内。子宫肌层不能收缩止血,导致子宫着床时大出血,最后为了挽救孕妇的生命而进行子宫切除术的情况时有发生。即使提前终止妊娠,流产时出血的风险也很高,而且很难止血,未来分娩的结果也难以预料。
- 2、子宫切口瘢痕破裂。随着妊娠周数的增加,子宫体积增大,宫腔内压力增大,子宫下段肌层变薄,肌纤维拉长。 弹性差,可能出现肌纤维断裂,可能出现子宫瘢痕破裂,严重者可能导致大出血、休克、母婴死亡。尤其是前次剖宫产间隔时间短,子宫切口愈合不良更常见。
- 3、产后出血原子宫切口结疤后,缺乏弹性,收缩力差。
- 4、手术和麻醉难度增加。患者上一次手术留下的组织粘连大大增加了第二次和第三次手术中手术损伤和感染的机会。
疤痕的子宫移植几个胚胎?
如果自然生育二胎或三胎有困难,试管婴儿是最后的“王牌”。 进入试管婴儿的过程,成功获得了几个胚胎,移植胚胎的时候,有点困难。由于试管婴儿技术可以移植两个胚胎,受孕率可达60%以上,而双胞胎受孕率则高达30~40%。妊娠晚期子宫有疤痕的子宫破裂风险显着增加,因此建议选择胚胎移植。
Tips:要注意的是,如果剖宫产后想要再生育一个孩子,最好在怀孕前到妇产科进行检查,以此来确保疤痕的子宫功能是否正常,是否具备再生产的条件,只有在十分安全的条件下才可以进行下一步。腹腔镜或经腹疤痕可修复,但这种手术是否能降低子宫破裂的风险在医学界仍有争议。
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