剖宫产术后再次妊娠分娩方式的选择

Repeat pregnancy delivery mode selection after cesarean section

目的探讨剖宫产术后再次妊娠分娩方式的选择。方法选取本院2011年10月～2012年10月230例剖宫产术后再次妊娠孕妇的临床资料进行回顾性分析,其中再次剖宫产(RCS)者160例,经阴道分娩(VBAC)者70例,随机选取同期首次剖宫产(PCS)160例和非瘢痕子宫阴道分娩(VBNC)70例进行比较。结果 RCS组产时出血量、住院时间、产褥病率方面均高于VBAC组,差异有统计学意义(P<0.05);RCS组在开腹至娩出时间、产时出血量、严重粘连率方面高于PCS组,差异有统计学意义(P<0.05);VBAC组与VBNC组在产时出血量、新生儿窒息发生率方面比较,差异无统计学意义(P>0.05)。结论临床工作中对有剖宫产史者应合理选择行阴道分娩,以降低剖宫产率及剖宫产术后远、近期并发症。

Objective To investigate the repeat pregnancy delivery mode selection after the cesarean section.Methods The clinical materials of 230 cases of repeat pregnancy after the cesarean section in our hospital from October 2011 to October 2012 were retrospectively analyzed,in which there were 160 cases of repeat cesarean section（RCS） patients,and 70 cases of vaginal childbirth（VBAC）.160 cases of primary cesarean section（PCS） and 70 cases of non-scarred uterus vaginal childbirth（VBNC） were randomly selected and compared at the same time.Results The intrapartum blood loss,duration of hospitalization,puerperal morbidity of the RCS group were higher than those of the VBAC group,with statistical difference（P＆lt;0.05）.The laparotomy to disengagement time,when the amount of bleeding,severe adhesion rate of the RCS group were higher than those of the PCS group,with statistical difference（P＆lt;0.05）.The comparison of intrapartum bleeding,neonatal asphyxia of VBAC group and VBNC group had no statistical difference（P＆gt;0.05）.Conclusion The clinical work should initiative reasonable choice history of cesarean section,vaginal delivery,in order to reduce the rate of cesarean section and cesarean section postoperative complication far and recent.