剖宫产术后再次妊娠分娩方式的选择分析

Analysis of pregnancies after cesarean section selection

目的:探讨剖宫产术后再次妊娠分娩方式的选择。方法:研究选择的对象共200例,均为剖宫产术后再次妊娠者,分为经阴道分娩50例(A组),再次剖宫产150例(B组)。随机抽取同期收治的非瘢痕子宫阴道分娩50例(C组),与首次剖宫产分娩150(D组)。将A组与C组对照,B组与D组对照。并对比A组、B组分娩结局。结果:200例患者中,试产成功率为72.5%;直接行剖宫产术占65.5%。A组与B组比较,产后出血量、平均住院费用、平均住院时间均呈较低水平,差异有统计学意义(P<0.05)。B组和D组比较,产后出血量、平均住院费用、平均住院时间均呈较高水平,差异有统计学意义(P<0.05)。A组与C组比较,产后出血量、住院费用、平均住院时间差异无统计学意义(P>0.05)。结论:剖宫产术后再次妊娠分娩方式选择中,直接剖宫产并非绝对指征,分析患者特点,与试产条件符合者,可规范操作,在严密监护下实施阴道试产,以降低剖宫产率,避免远期并发症,提高分娩质量。

Objective To investigate the pregnancies after cesarean section selection.Methods The object of this study is to choose a total of 200 patients,both after cesarean section pregnancy, divided into vaginal delivery in 50 cases（group A）,cesarean section in 150 cases（group B）.50 cases of non scar uterus vaginal delivery were randomly selected（group C）,and the first cesarean section 150（group D）.The A group and C group,B group and D group.Compared with group A,group B delivery outcome.Results Of the 200 patients,the success rate of labor was 72.5%;cesarean delivery directly accounted for 65.5%.Comparison between A group and B group,the amount of postpartum hemorrhage,the average hospitalization expenses,the average hospitalization time was low,the difference was statistically significant（P 〈 0.05）.B group and D group,the amount of postpamun hemorrhage,the average hospitalization expenses,the average hospitalization days were higher, the difference was statistically significant（P 〈 0.05）.Comparison between A group and C group,the amount of postpartum bleeding,hospitalization expenses,the average hospitalization days had no significant difference（P 〉 0.05）.Conclusiun Pregnancy after cesarean section delivery mode selection,direct cesarean section is not the absolute indications,analysis of patient characteristics,and production conditions,can regulate the operation,the implementation of vaginal delivery in intensive care,in order to reduce the rate of cesarean section,avoid long-term complications,improve the quality of delivery.