剖宫产术后再次妊娠不同分娩方式结局的临床比较

Comparasion on the Clinical Outcome of Different Delivery Mode of Repregnancies after Cesarean Section

目的：比较剖宫产术后再次妊娠产妇不同产科处理的结局，探讨阴道分娩可行性及注意事项。方法：回顾性分析2010年1月-2012年12月320例我院住院待产剖宫产术后再次妊娠的孕妇的临床资料。结果：320例剖宫产术后孕妇阴道试产分娩成功50例，产程、产时出血、新生儿Apgar评分、住院时间与同期按照1：1随机选择的50例初产妇的比较均无统计意义上差异（P〉0.05）；剖宫产术后孕妇阴道再次剖宫产术的270例开腹至胎儿娩出时间产后出血、盆腔粘连发生率、住院时间天高于同期按照1：1随机选择的270初产妇剖宫产（P〈0.05）。结论：对于剖宫产后再次妊娠待分娩孕妇，阴道分娩与初产妇的相比对新生儿结局的影响没有差别，再次剖宫产术后孕妇胎儿娩出时间、产后出血、盆腔粘连、住院时间高于初产妇剖宫产组，应给予阴道试产的机会最大限度地降低剖宫产率，提高产科质量。

Objective：To compare maternal obstetric treatment of different endings of repregnancy after cesarean section, to explore the feasibility of vaginal delivery and precautions.Methods：A retrospective analysis from 2010 January-2012 year in December, the clinical data of 320 cases of delivery after cesarean section pregnancy pregnant women in our hospital.Results：320 cases of cesarean section maternal vaginal delivery was successful in 50 cases, birth process, hemorrhage, Apgar score of neonates,hospitalization time and over the same period in accordance with the maternal 50 cases of 1：1 randomly selected were no statistical significance compared difference（P〉0.05）;after cesarean section maternal vaginal again cesarean section of 270 cases of open to childbirth time of postpartum hemorrhage, pelvic adhesions occurred in 1,time of hospitalization days in the same period in accordance with the 1：1 random selection of 270 primiparae cesarean section （P〈0.05）.Conclusion：Repregnancy after cesarean section for pregnant women, have no difference compared with nulliparous women with vaginal delivery on neonatal outcomes, again after cesarean section maternal fetal childbirth time, postpartum bleeding,pelvic adhesion, hospitalization time higher than that of primiparae cesarean section group,should be given the opportunity of vaginal delivery to minimize section section rate, improve the quality of obstetric.