剖宫产后再次妊娠时分娩方式的选择及妊娠结局的研究

The choice of delivery mode in subsequent pregnancy after cesarean section and its pregnancy outcomes

目的研究剖宫产后再次妊娠时分娩方式的选择及妊娠结局。方法将妇产科收治的剖宫产术后再次妊娠的产妇纳入研究,根据再次妊娠时分娩方式不同分为接受阴道分娩的观察组和接受剖宫产分娩的对照组。观察两组患者的分娩结局、产后负面情绪及远期生活质量。结果观察组患者产后出血量(109.6±25.1)vs(318.5±43.8)mL、分娩后卧床时间(2.1±0.3)vs(5.4±0.8)d以及HAMA评分(13.4±1.9)vs(21.5±3.1)、HAMD评分(14.3±1.9)vs(22.1±3.2)、NRS评分(1.5±0.4)vs(2.7±0.6)均低于对照组;观察组产妇的产后生活质量评分高于对照组。结论剖宫产术后再次妊娠时严格把握指征进行阴道分娩有助于减少产后出血量、促进产后恢复、缓解负面情绪、提高远期生活质量,是剖宫产术后再次妊娠时理想的分娩方式。

Objective To study the choice of delivery mode in subsequent pregnancy after cesarean section and its pregnancy outcomes. Methods Subsequent pregnancy patients after cesarean section were enrolled and divided into observation group and control group. Then outcome of delivery,postpartum negative emotions and long term quality of life were observed. Results Postpartum hemorrhage volume（109.6±25.1）vs（318.5±43.8）mL, bedding time（2.1±0.3）vs（5.4±0.8）d and HAMA（13.4±1.9）vs（21.5±3.1）,HAMD（14.3±1.9）vs（22.1±3.2）,NRS score（1.5±0.4）vs（2.7±0.6） of observation group were less than control group; life quality score were higher than control group. Conclusion Vaginal delivery in subsequent pregnancy after cesarean section has positive clinical value for it can reduce puerperal hemorrhage, promote postpartum recovery, alleviate negative mood, improve the quality of life.