疤痕子宫再次妊娠不同分娩方式的临床比较

Clinical Comparison of Different Delivery Modes for Repeated Pregnancy in Scar Uterus

目的探讨疤痕子宫再次妊娠行剖宫产与阴道分娩对分娩结局的影响。方法将该院2012年12月—2013年12月接收的疤痕子宫再次妊娠100例产妇设为观察组,将同期我院接收的非疤痕子宫分娩者设为对照组,对比两组的分娩结局。结果观察组100例中阴道试产50例,成功者为40例,占比为80.0%,其较之于对照组阴道分娩的产时出血量、产程、新生儿窒息、新生儿Apgar评分以及住院时间均差异无统计学意义(P>0.05);观察组再次剖宫者较之于对照组首次剖宫者的产时出血量、手术时间、切口愈合时间以及住院时间均较长(P<0.05)。结论疤痕子宫再次妊娠者行阴道分娩为一种经济、有效且安全的分娩方式,但应密切观察产程进展,并做好中转手术准备,以防止子宫破裂。

Objective To explore the effect of cesarean section and vaginal delivery on the delivery outcome of repeated pregnancy in scar uterus. Methods 100 puerperants with repeated pregnancy in scar uterus admitted in our hospital from December 2012 to December 2013 were set as the observation group, and puerperants without scar uterus admitted during the same period were set as the control group. And the delivery outcome was compared between the two groups. Results Of the 100 cases in the observation group, 50 cases tried vaginal delivery, of them, 40 cases were successful, accounted for 80.0%, and the differences in amount of intrapartum hemorrhage, duration of labor, neonatal asphyxia, neonatal Apgar score and the length of hospital stay between them and the control group were not statistically significant（P〉0.05）; the amount of intrapartum hemorrhage, duration of operation, incision healing time, and the length of stay of the puerperants with second cesarean section in the observation group were more than those of the puerperants with first cesarean section in the control group（P〈0.05）. Conclusion For women with repeated pregnancy in scar uterus, vaginal delivery is an economic, effective and safe delivery mode, but the development of labor should be closely observed, and the preparation of converting to operation should be well done so as to prevent the incidence of rupture of uterus.