瘢痕子宫再次妊娠阴道分娩的临床观察

Clinical observation of vaginal delivery of subsequent pregnancy in patients with scarred uterus

目的探讨瘢痕子宫再次妊娠选择阴道分娩的临床效果。方法回顾性分析我院产科2010年1月-2014年1月收治瘢痕子宫阴道试产患者32例分娩资料。另选取我院同期收治的瘢痕子宫妊娠剖宫产患者25例作为对照组,并对两组患者产程时间、子宫破裂、出血、新生儿窒息、平均住院时间等情况进行临床观察。结果瘢痕子宫阴道试产患者32例中阴道分娩24例,阴道分娩率为79.17%;两组患者产程时间、Apger评分比较差异无统计学意义（P〉0.05）,观察组术中出血量、产后出血量、平均住院时间与对照组比较均存在显著差异（P〈0.05）;两组患者并发症发生率比较差异有统计学意义（P〈0.05）。结论通过严密产程观察,瘢痕子宫患者行阴道分娩是安全、方便的,能够有效减少手术痛苦,减少并发症发生。

Objective To study the clinical effect of vaginal delivery of subsequent pregnancy in patients with scarred uterus. Methods 32 patients with scarred uterus who were treated with trial of labor were random Ly analyzed, while the other 25 patients with scarred uterus who were treated with cesarean section were selected as the control groups, in our hospital from January 2010 to January 2014. To observe the labor time, uterine rupture, hemorrhage, neonatal asphyxia, and the average hospital stay and other situation of the two groups. Results Of the 32 patients with scarred uterus who were treated with trial of labor, the vaginal delivery rate was 79.17% with 24 patients treated with vaginal delivery. The labor time and Apger score was no statistical significance compared with the two groups（P〈0.05）. The intraoperative blood loss, the amount of postpartum bleeding, and the average hospital stay was statistical significance in treatment group compared with which in control group（P〈0.05）. The complication rate between the two groups was statistical significance（P〈0.05）. Conclusion Under close monitoring of duration of labor, vaginal delivery in patients with scarred uterus is safe and convenient, could effectively reduce the operative pains and complications.