摘要
目的探讨瘢痕子宫再次妊娠(CSP)阴道试产成功的保护因素,总结其护理风险防控要点。方法选取2017年8月至2018年8月82例瘢痕子宫产妇作为研究对象,根据分娩方式分为阴道试产和剖宫产,采用logistic回归分析确定影响产妇试产成功的保护因素。结果82例产妇中,阴道试产32例,成功者27例(84.38%),5例阴道试产失败转急诊剖宫产术治疗;行剖宫产者55例(67.07%);所有产妇未出现子宫破裂现象。产前BMI<30 kg/m^2、距上次剖宫产时间为3年、使用宫缩剂、子宫下段厚度>3.9 mm、胎龄<40周均是影响CSP产妇阴道试产成功的单因素;孕妇产前BMI(<30 kg/m^2)、距前次剖宫产时间(≥3年)及子宫下段厚度(>3.9 mm)是影响CSP产妇阴道试产成功的独立保护因素。结论瘢痕子宫再次妊娠产妇可依据前次剖宫产指征、子宫恢复情况、并发症等选择阴道试产,其中孕妇产前BMI<30 kg/m^2、距前次剖宫产时间在3年以上及子宫下段厚度>3.9 mm是影响阴道试产成功的保护因素,临床护理需积极采取风险防控措施可提高阴道试产成功率,改善母婴结局。
Objective To explore the successful protective factors of vaginal trial-produce in cesarean scar re-pregnancy(CSP),and summarize the main points of prevention and control of nursing risk.Methods We selected 82 cases of scar uterus from August 2017 to August 2018 as a study object.The vaginal trial-produce and cesarean section were divided according to the mode of delivery.Logistic regression analysis was used to determine the protective factors affecting the success of maternal trial-produce.Results In the 82 cases of maternals,32 cases were vaginal trial-produce,27 cases(84.38%)were successful,5 cases of failing vaginal trial-produce were transferred to emergency cesarean section;55 cases(67.07%)of patients underwent cesarean section;all maternals had no uterine rupture.The prenatal BMI of maternals was<30 kg/m^2,the time from the last cesarean section to 3 years,the use of uterotonic,the thickness of the lower segment of uterus>3.9 mm,and gestational age<40 weeks were the single factors that affected the success of vaginal trial-produce in CSP maternal.The prenatal BMI of maternals(<30 kg/m^2),the time from the previous cesarean section(≥3 years),and the thickness of the lower segment of uterus(>3.9 mm)were independent protective factor affecting the success of vaginal trial-produce.Conclusion The vaginal trial-produce could be selected for maternals with CSP according to the previous indications of cesarean section,recovery situation of uterine,complications,etc.,in which the prenatal BMI of maternals was<30 kg/m^2,the time from the previous cesarean section was more than 3 years,and the thickness of the lower segment of uterus>3.9 mm were a protective factor affecting the success of vaginal trial-produce.Clinical care needed to take risk prevention and control measures to improve the success rate of vaginal trial-produce and improve maternal and child outcomes.
作者
陈慧
宁宁
CHEN Hui;NING Ning
出处
《护理实践与研究》
2019年第21期7-9,共3页
Nursing Practice and Research
关键词
瘢痕子宫再次妊娠
分娩方式
阴道试产成功因素
护理风险防控
Re-pregnancy of scar uterus
Delivery mode
Success factor of vaginal trial-produce
Prevention and control of nursing risk
