中国式分娩：剖宫产率30年飙升9倍 Chinese labor：Cesarean section rate 30 years soared 9 times

　　

胚胎在子宫疤痕处“安家”穿透子宫危及生命 Embryo in the womb in scar“home”Penetration uterine endanger life

　　

妇产科专家感慨：我们正在品尝高剖宫产率的苦果 Department of gynaecology and obstetrics experts regrets：We are taste high cesarean section rate was a bitter pill

　　如今，许多女孩子都有这样的想法：生孩子很疼，不如打上麻醉来一刀，选择剖宫产。

now，Many girls have such idea：Children very ache，As a anesthesia to a sword，Choose cesarean section。

　　在中国，剖宫产率约为46.5%，30年飙升了9倍，高居世界第一。

In China，Cesarean section rate is about 46.5%，30 years surged 9 times，At the world。

　　在省立同德医院，近四个月接诊了7例疤痕妊娠女性，其中1例已经大出血危及生命。这种疾病，在国内上世纪90年代中期才被首次报道，如今发病率却越来越高。妇产科专家感慨，“我们正在品尝高剖宫率的苦果。”

In the provincial hospital with Germany，Nearly four months accepts the 7 cases scar pregnancy women，One example has been hemorrhaging endanger life。The disease，In China only the mid 1990 s was first reported，Now is more and more high incidence。Department of gynaecology and obstetrics experts regrets，“We are taste high cutting rate of the bitter legacy of the palace。”

　　

子宫破了，自己都不知道已怀孕 Uterus is broken，You don't know already pregnant

　　7月29日，25岁的李女士因下体出血过量出现休克，被送进省立同德医院。

July 29,，25 for ms. Li nakedness excessive bleeding in shock，Was sent to provincial hospital with Germany。

　　“已断断续续出血1周，来就诊的前两天出现大血块。”妇产科吕雯主任介绍，患者的肚子鼓鼓的，血压很低，血小板只有2万左右(常人约10—30万)，B超显示腹腔内有血块。

“Has been off and on bleeding 1 week，To see a doctor in two days before the big blood clot。”Department of gynaecology and obstetrics LvWen director is introduced，Patients in the stomach bulging，Blood pressure is very low，Platelet only 20000 or so(Ordinary people about 10-300000)，B to exceed display abdominal cavity were blood clot。

　　进行紧急开腹手术，术中发现李女士的子宫已破裂。为什么会破裂呢？发现是疤痕妊娠。

Make an emergency laparotomy，Intraoperative found ms. Li uterus already broken。Why will break up？Discovery is scar pregnancy。

　　“孕囊在子宫着床，但刚好落到破宫产后子宫的疤痕处。”吕主任说。

“Gestational sac in the womb implantation，But just fall broken palace postpartum uterine scar place。”Director lu said。

　　原来，李女士生过一胎，是剖宫产的，现在又怀上第二胎，“之前月经停了1个月，我自己都不知道已经怀孕，出现出血还以为是来月经。”李女士说。

The original，Ms. Li gave birth to one child，Cesarean section is the，Now conceived again a second child，“Before menstruation stop for a month，I don't know myself is pregnant，Appear haemorrhage thought come to menstruation。”Ms. Li said。

　　子宫像一个房间，疤痕部位像墙上修补过的一条缝隙，该部位肌肉组织少、血供少，胚胎在这里着床发育，可以向子宫里面生长，也可能向外生长。向外生长的话，子宫壁就会被穿透，造成子宫破裂。向里面生长虽然危险性小一点，但同样有可能造成出血。

Uterine like a room，Scar like the wall repaired a gap，The region less muscle tissue、Less blood supply，Embryo implantation development here，Can to womb growth，May also outward growth。Outward growth words，Uterine wall will be penetration，Cause uterine rupture。Inside growth although little risk，But there are also may cause bleeding。

　　医生将李女士子宫旧疤痕及胚胎做了切除、缝合，“术中出血1500毫升，患者凝血功能极差，术前和术后出了多少血就难估计了，病情相当危险。”吕主任说。

The doctor will ms. Li uterine old scar and embryo do excision、suture，“Intraoperative bleeding 1500 ml，Patients with poor function of blood coagulation，Preoperative and postoperative out how much it is difficult to estimate the blood，Illness very dangerous。”Director lu said。

　　

四个月接诊7例疤痕妊娠 Four months accepts 7 cases scar pregnancy

　　其实，李女士是省立同医院医院今年接诊的第6例疤痕妊娠患者。

In fact，Ms. Li is provincial hospital with hospital became this year 6 cases of scar pregnancy patients。

　　吕雯主任调出电脑里的存档资料，今年第一例患者是4月12日接诊的，四川自贡人，姓陈，才24岁。停经1个月多，腹痛，B超检查发现是疤痕妊娠，“胚胎已往外长，还有3毫米就要穿透子宫，很危险。”

LvWen director decruitment computer archive material，This year the first patient is April 12 became，Sichuan zigong people，Family name is Chen，Only 24 years old。Menopause more than 1 month，Abdominal pain，B to exceed examination revealed is scar pregnancy，“Embryonic foretime foreign minister，There are 3 mm will penetrate the uterus，It is dangerous to。”

　　最近一例患者是8月10日接诊的，也是B超发现。患者还没出血，做了直视人流手术后安全出院。

Recent patient is on August 10th became，Is B to exceed found。Patients haven't bleeding，Do look into the stream of people surgery safety after hospital discharge。

　　从4月份至今，省立同德医院已经接诊7例疤痕妊娠患者，而且都是30岁以下的年轻女性。那么，这种病例是不是一直以来就像感冒那样常见呢？

So far from April，Provincial tongde hospitals have been accepts 7 cases scar pregnancy patients，And it is 30 years old the following of young women。so，This case is always like a cold? So common？

　　1970年，国际上第一次报道疤痕妊娠；

In 1970,，The international first reported scar pregnancy；

　　1994年，协和医学大学第一次在国内报道疤痕妊娠；

In 1994,，Union medical university for the first time in domestic reports scar pregnancy；

　　1998年，有研究认为，在破宫产女性中疤痕妊娠的发生率约为3:1000；

In 1998,，Studies have think，In the palace production women scar pregnancy incidence of about, "；

　　但是，最新的研究报告指出，疤痕妊娠在剖宫产女性中发生率约为15%，而且正在逐年上升。原因有两点，一是破宫产率的上升，二是低避孕率，很多人对节育环、口服避孕药排斥，又不会正确使用安全套，造成意外怀孕。

but，The latest research report says，Scar pregnancy in women in cesarean section rate is about 15%，And are on the increase。There are two reasons for，One is broken palace production rate rise，The second is the low BiYunLv，A lot of people on the loop、Oral contraceptive rejection，Does not the correct use of condoms，Cause accidental pregnancy。

　　“我们正在品尝高剖宫产率的苦果。”吕雯主任说，妇产科的很多知名专家都有同样的感慨。

“We are taste high cesarean section rate was a bitter pill。”LvWen director said，Department of gynaecology and obstetrics a lot of famous experts have the same feeling。

　　

中国：剖宫产率30年飙升9倍 China：Cesarean section rate 30 years soared 9 times

　　1985年，世界卫生组织对于剖宫产比率设置了一条警戒线：低于15%。

In 1985,，The world health organization for cesarean section rate set up a cordon：Less than 15%。

　　2007年到2008年，世界卫生组织在全球范围进行了调查：在拉美、非洲、亚洲总共选了25个国家作为样本。在中国，取样北京、浙江、云南三省21家医院，结果显示，中国总剖宫产率为46.5%。而亚洲平均为27%，南美洲为30%，非洲是百分之十几。

From 2007 to 2008，The world health organization in the global range were investigated：In Latin America、Africa、Asia a total of chose 25 countries as a sample。In China，Sampling Beijing、zhejiang、Yunnan provinces and hospitals，Results show that，China's total cesarean section rate was 46.5%。While Asian an average of 27%，South America is 30%，Africa is more than a dozen per cent。

　　上世纪70年代，中国的剖宫产率仅为5%左右，采用剖宫产分娩的产妇30年增加了9倍。

In the 1970 s，China's cesarean section rate is only 5%，The cesarean section delivery of the parturient women 30 years increased nine times。

　　根据英国著名医学杂志《柳叶刀》2010年的数据，中国25%的剖宫产并不是出于医疗需要，是可以避免的，即每年500万例的剖宫产其实可以自然分娩。

According to the famous British medical journal《The lancet》2010 years of data，25% of China's cesarean section and not from medical need，Can be avoided，That is every year 5 million cases of cesarean section could actually natural childbirth。

　　“剖宫产妈妈的死亡率，按人群说，要比自然分娩产妇的死亡率高。麻醉意外要多、羊水栓塞要多、术后感染要多，其危险性要比顺产妈妈高得多。但公众存在错误认识，以为剖宫产就安全了。”中国妇幼保健协会副会长、专家委员会主任委员庞汝彦说。

“Cesarean section mother's mortality，According to the crowd said，Than natural childbirth puerpera higher death rate。Anesthesia more accident、Amniotic fluid embolism to many、More postoperative infection，Its risk than eutocia mother much higher。But the public know errors，Think cesarean section is safe。”China's maternity and child care vice chairman of the association、The chairman of the committee PangRuYan expert committee said。

　　

剖宫产后避孕两年以上再怀孕 Contraception after cesarean section for more than two years pregnant again

　　今年4月5日，小S生下了第三胎，她已经连剖了三个女儿。

This year April 5，Small S gave birth to the third fetal，She has even cutting the three daughters。

　　大女儿生于2006年1月16日，大名许曦文，小名许俏妞；二女儿生于2007年11月24日，大名许韶恩，英文名Lily；三女儿生于2012年4月5日，英文名Alice。

The older daughter was born in January 16, 2006，Name XuXiWen，Childhood name XuQiaoNiu；Second daughter was born on November 24, 2007，Name XuShaoEn，English name Lily；Three daughter was born in April 5, 2012，English name Alice。

　　有人疑问，女人一生究竟能剖多少次，剖宫产后多久才能怀孕？

Some doubt，A woman's life on earth can cut many times，How long can be pregnant after cesarean section？

　　吕主任介绍，生第一胎时，自身条件具备的，最好顺产。有过一次破宫产的女性，生第二胎时一般也做剖宫产，因为自然分娩会增加子宫破裂风险，“最好是剖宫产后避孕两年以上再怀孕，使子宫有足够的时间让疤痕长得牢固。”

Director lu introduced，When the birth of their first child，Their own conditions have，The best eutocia。Had a broken palace production of women，When second birth generally do cesarean section，Because natural childbirth can increase the risk of rupture of uterus，“The best contraceptive is after cesarean section for more than two years pregnant again，Make uterine have enough time to let scar grow strong。”

　　另外，疤痕妊娠是概率性的事件，对于已经剖宫产过的女性来说，目前还没法去规避，但是可以通过B超检查早发现，减少大出血危险。

In addition，Scar pregnancy is probabilistic event，To have a cesarean section for women，At present also can't go to evade，But by B ultrasonic examination can be found early，Reduce hemorrhage risk。

　　孕早期出现阴道少量流血常常是疤痕子宫妊娠的首发症状。这个症状与先兆流产、宫外孕等相似，一经确诊为疤痕妊娠应立即终止妊娠。因为一方面这个胚胎很难存活。另一方面，这个胚胎也很有可能穿破子宫，造成大出血，危及孕妇的生命。(记者 余敏 通讯员 楼建丽)

Early stages of pregnancy appear vaginal bleeding is often a scar uterine pregnancy symptoms start。The symptoms and threatened abortion、Ectopic pregnancy and similar，Once diagnosed with scar pregnancy shall immediately terminate pregnancy。Because on one hand the embryo is hard to survive。On the other hand，The embryos are also very likely wear out uterus，Massive haemorrhage，Endanger the life of pregnant women。(Reporter correspondent LouJianLi 13)