摘要
目的调查初产妇及经产妇不同情况下分娩方式的选择,并对其分娩结局进行交叉比较。方法回顾性分析天津医科大学总医院妇产科2013年1月1日—2014年12月31日入院分娩产妇7 509例的临床资料,其中初产妇6 229例,经产妇1 280例。统计初产妇和经产妇阴道分娩和剖宫产例数及经产妇中剖宫产者的剖宫产指征构成比,比较初产妇及瘢痕子宫孕产妇再次妊娠选择阴道分娩与剖宫产的比例及结局。结果经产妇剖宫产率高于初产妇(69.06%vs.57.54%,χ2=59.19,P<0.05)。其中瘢痕子宫妇女再次妊娠631例,经阴道分娩39例(6.18%),再次剖宫产592例(93.82%)。经产妇选择剖宫产的手术指征以瘢痕子宫为主。初产妇及瘢痕子宫孕产妇选择阴道分娩结局与剖宫产相比新生儿体质量较轻,孕产妇住院时间较短,产后24 h出血量和产后发热例数均较少(均P<0.05),在新儿评分方面差异无统计学意义。初产妇与瘢痕子宫孕产妇选择阴道分娩结局差异无统计学意义。瘢痕子宫经产妇再次剖宫产与初产妇首次剖宫产相比,会增加孕产妇产后24 h出血量和产后发热例数(P<0.05)。结论经产妇再次分娩仍以剖宫产为主;瘢痕子宫经产妇再次妊娠经阴道分娩的结局明显优于首次和再次剖宫产者,经阴道分娩是孕产妇较为安全的分娩方式。
Objective To study the different selections of delivery mode of pregnant women,and compare their outcomes.Methods Data of 7 509 pregnant women hospitalized in the General Hospital of Tianjin Medical University between January 2013 and December 2014 were retrospectively analyzed.Of them,there were 6 229 cases of primipara and1 280 cases of multipara.The numbers of vaginal delivery and cesarean delivery were statistical analyzed between primipara and multipara.The cesarean delivery indications of multipara was also studied.The vaginal delivery rates and cesarean delivery rates,and their outcomes were compared between primipara and scar uterus maternal pregnancy.Results The cesarean delivery rate was higher in multipara than that of primipara(69.06%vs.57.54%,χ~2=59.19,P< 0.05).Among them,631 cases were uterine scar pregnancy,39 cases(6.18%) were vaginal delivery and 592 cases(93.82%) were cesarean delivery.The uterine scar was the main indicator for cesarean delivery in multipara.Compared the outcomes of cesarean delivery,the weight of neonatal body mass was relatively light,the hospital stay was shorter,the amount of 24 h postpartum bleeding and postpartum fever were less in vaginal delivery in primipara and pregnant women with uterine scar(P<0.05).There were no significant differences in scores of newborn.There were no significant differences in outcomes of vaginal delivery between primipara and pregnant women with uterine scar.Compared outcomes of cesarean delivery between multipara with scar uterus and primipara,there were increased maternal blood loss and postpartum fever in multipara with scar uterus(P<0.05).Conclusion The cesarean delivery is still the mainly mode for multipara.The vaginal delivery is the best mode for pregnant women with scar uterus compared with that of primipara.The vaginal delivery is the safer way of delivery for pregnant women.
出处
《天津医药》
CAS
2016年第10期1280-1282,共3页
Tianjin Medical Journal
关键词
分娩
剖宫产术
阴道分娩
剖宫产后阴道分娩
瘢痕子宫
parturition
cesarean section
vaginal delivery
vaginal birth after cesarean
scarred uterus
