摘要
目的分析剖宫产术后瘢痕子宫再次妊娠阴道分娩方式,研究瘢痕子宫阴道分娩的可行性。方法纳入在本院分娩的164例剖宫产术后瘢痕子宫再次妊娠的产妇,根据分娩方式不同分为瘢痕阴道组52例和瘢痕剖宫组112例,比较两组产后指征、并发症、新生儿情况。同时将瘢痕剖宫组患者与同期114例无瘢痕子宫且首次行剖宫产孕妇(首次剖宫组)和同期134例首次阴道分娩的孕妇(首次阴道组)进行比较。结果瘢痕阴道组产后24h出血量、产后发热率、新生儿窒息率和住院天数显著低于或少于瘢痕剖宫组(P<0.05);而两组产褥病率、新生儿体重、窒息率和新生儿Apgar评分差异无统计学意义(P>0.05);瘢痕剖宫组患者前次剖宫产和本次剖宫产比较,瘢痕子宫、胎儿窘迫、胎位异常、产程停滞、先兆子宫破裂、妊娠合并内科疾病和社会因素手术指征存在显著性差异(P<0.05),其他差异不显著(P>0.05);瘢痕阴道组和首次阴道组分娩结局比较差异不显著(P>0.05);瘢痕剖宫组产后24h出血量和住院天数显著多于首次剖宫组(P<0.05),而两组产褥病率和新生儿情况比较,差异无统计学意义(P>0.05)。结论瘢痕子宫再次妊娠阴道分娩可显著降低母婴并发症发生,产妇住院时间短、恢复快,对新生儿伤害小,在严格掌控阴道试产指征和严密监测产程情况下,应鼓励瘢痕子宫妊娠产妇首选阴道分娩。
Objective To analyze the feasibility of re-pregnancy vaginal delivery of cesarean scar uterine. Methods 164 patients with re-pregnancy after cesarean section were divided into scar virginal group （n= 52） and scar cesarean section group （n= 112）, according to the different modes of delivery. The postpartum indications, complications and neonatal conditions were compared between the two groups, and the scar cesarean section groupscar vaginal group was compared with 114 patients without scarred uterine and undergoing cesarean section for the first time （first cesarean section group） and 134 women undergo- ing vaginal delivery for the first time （first vaginal group）. Results The postpartum 24h blood loss, incidence rates of postpartum fever, neonatal asphyxia and the length of hospital stay in the scar vaginal group were significantly lower than those in the scar cesarean section group （P〈0. 05）. There were no significantly difference in puerperal disease rate, neonatal birth weight, newborn asphyxia rate and Apgar score between the two groups （P〉0. 05）. Compared the cesarean section with previous cesarean section, there were significant differences in scarred uterine, fetal distress, fetal abnormalities, labor stagnation, threatened uterine rupture, pregnancy with internal medicine diseases and social factors surgical indications in the scar cesarean section group （P〈0.05）, while the other aspects showed none significant differences （P〉 0.05）, and the pregnancy outcomes also showed none significant differences （P〉0. 05）. The postpartum 24h blood loss and length of hospital stay of scar cesarean section group were significantly more and longer than those of the first cesarean section group （P〈0. 05）. There were no significantly difference in puerperal disease rate, neonatal birth weight, newborn asphyxia rate and Apgar score between the two groups （P〉 0. 05）. Conclusion Re-pregnancy vaginal delivery of scarred uterine can significantly reduce maternal and neonatal complications,shorten length of stay and has little effect on newborns. Under the condition of strict control of indications of vaginal delivery and close monitoring of labor conditions, vaginal delivery is recommended for women with scarred uterine and re-pregnancy.
出处
《西部医学》
2017年第5期666-669,共4页
Medical Journal of West China
基金
陕西省科学技术研究发展计划项目(2013K14-02-12)
关键词
瘢痕子宫
剖宫产后阴道分娩
再次妊娠
临床分析
Scarred uterus
Vaginal delivery after cesarean section
Re-pregnancy
Clinical analysis
