臨床婦人科産科64巻10号

2010年10月発行

今月の臨床 ハイリスク妊娠─ここがチェックポイント

妊娠のリスク診断と管理の実際

2．妊娠中・後期のチェックポイント　6）既往子宮手術のリスク評価と管理

著者： 板倉敦夫¹

所属機関： ¹埼玉医科大学産科婦人科

ページ範囲：P.1419 - P.1423

文献概要

はじめに

　既往子宮手術妊娠・分娩に関する最も重要視すべきリスクは，子宮破裂である．しかし，子宮破裂の頻度は少なく，実際の臨床現場では腹腔内癒着や分娩時・手術中の出血量なども問題となる．既往子宮手術妊娠の管理方針は，近年の産科医療を取り巻く環境の変化によって，大きく変わっている．妊娠・分娩時のリスク評価を行い，適切な管理が求められ，さらには妊産婦にもエビデンスに基づいた説明が必要となる．本稿では，既往帝王切開，既往子宮筋腫核出での妊娠・分娩時のリスクと管理について論文を引用しながら解説する．

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