剖宫产术后再次妊娠分娩方式的临床分析

Clinical analysis on delivery mode of subsequent pregnancy after cesarean section

目的:了解剖宫产术后再次妊娠时分娩方式的选择情况。方法:选取乐清市第二人民医院分娩的有剖宫产手术史的110位孕妇,对她们再次妊娠的分娩方式和分娩结局进行分析。按照孕妇的意愿有62例孕妇选择再次剖宫产,有48例孕妇选择经阴道分娩。从住院时间、出血量、产褥感染、新生儿感染、新生儿窒息等指标比较两种分娩方式对母婴的影响。结果:对产妇影响:①出血量方面:选择剖宫产者出血量为(290.69±5.63)ml,而经阴道分娩者为(162.40±8.30)ml,两种方法相比有统计学差异(P<0.05);②住院时间:选择剖宫产孕妇的住院时间为(7.32±1.04)天,而经阴道分娩者为(3.14±0.89)天,两种方法相比有统计学差异(P<0.05);③产褥感染:选择剖宫产的孕妇发生感染8例,占12.9%(8/62),而经阴道分娩感染1例,占2.08%(1/48),两种方法相比有统计学差异(P<0.05)。对婴儿影响:①新生儿感染:选择剖宫产的孕妇发生新生儿感染3例,占4.84%,而经阴道分娩发生新生儿感染1例,占2.08%,两种方法相比无统计学差异(P>0.05);②新生儿窒息:剖宫产的孕妇中发生新生儿窒息2例,占3.23%,而经阴道分娩发生1例,占2.08%,两种方法相比无统计学差异(P>0.05)。结论:具有剖宫产手术史的孕妇在选择妊娠方式时,可以考虑采用经阴道分娩。

Objective：To understand the choice of delivery mode of subsequent pregnancy after cesarean section.Methods：110 pregnant women with the history of cesarean section were selected from the hospital,their delivery mode and delivery outcome of subsequent pregnancy were analyzed.According to the demands of the pregnant women,62 pregnant women chose secondary cesarean section and 48 pregnant women chose vaginal delivery.The effects of the two delivery modes on maternal and infantile outcomes were compared in terms of hospitalization time,the amount of blood loss,puerperal infection,neonatal infection and asphyxia.Results：The effects on lying-in women： ①the amount of blood loss： the amounts of blood loss in cesarean section group and vaginal delivery group were（290.69±5.63） ml and（162.4±8.3） ml,respectively,there was significant difference between the two groups（P0.05）;②hospitalization time： the hospitalization times of cesarean section group and vaginal delivery group were（7.32±1.04） days and（3.14±0.89） days,respectively,there was significant difference between the two groups（P0.05）;③puerperal infection： the proportions of puerperal infection in cesarean section group and vaginal delivery group were 12.9%（8 cases） and 2.08%（1 case）,respectively,there was significant difference between the two groups（P0.05）.The effects on infants： ①neonatal infection： the incidences of neonatal infection in cesarean section group and vaginal delivery group were 4.84%（3 cases） and 2.08%（1 case）,respectively,there was no significant difference between the two groups（P 0.05）;②neonatal asphyxia： the incidences of neonatal asphyxia in cesarean section group and vaginal delivery group were 3.23%（2 cases） and 2.08%（1 case）,respectively,there was no significant difference between the two groups（P 0.05）.Conclusion：When the pregnant women with the history of cesarean section want to select delivery mode,they can consider vaginal delivery.