剖宫产后再次妊娠分娩方式的临床分析

Clinical analysis on delivery mode of the subsequent pregnancy after cesarean section

目的探讨剖宫产后再次妊娠分娩方式的临床分析。方法回顾性分析2010年5月～2012年3月157例剖宫产术后再次妊娠分娩的孕妇,比较再次剖宫产分娩和阴道分娩的母婴并发症情况。结果本组157例孕妇,阴道试产78例,试产成功51例,成功率为65.4%。再次剖宫产106例,剖宫产率为67.5%。106例再次剖宫产孕妇产后出血量、产后感染发生率及住院天数均显著高于阴道分娩者,差异均具有统计学意义(P<0.05)。再次剖宫产组与阴道分娩组新生儿感染、新生儿窒息发生率比较差异无统计学意义(P>0.05)。结论剖宫产术后再次分娩方式选择应视孕妇具体情况而定,在符合阴道分娩适应证的情况下,阴道试产是安全可行的。

Objective To explore the delivery mode options of the subsequent pregnancy after cesarean section. Methods One hunderd and fifty-seven subsequent pregnant women after cesarean section from May 2010 to March 2012 were stud- ied retrospectively, perinatal and child outcome of repregnancy and vaginal delivery were compared. Results Of 157 cases, 78 cases chose vaginal trial production, 51 cases who chose vaginal delivery were successful, the success rate was 65.4%, 106 cases chose cesarean section, cesarean section rate was 67.5%. The postpartum hemorrhage, postpartum infection and hospital time in repregnancy group were all higher than those in the vaginal delivery group, the differences were statistical- ly significant （P 〈 0.05）. The incidence of neonatal infection and asphyxia between two groups had no statistically signifi- cant difference （P 〉 0.05）. Conclusion The delivery mode options of the subsequent pregnancy after cesarean section should be depend on the specific situation of pregnant women, in the case of vaginal delivery indications, vaginal trial pro- duction is feasible and safe.