疤痕子宫再次妊娠分娩安全性的探讨

目的探讨疤痕子宫再次妊娠分娩的安全性。方法收集妊娠足月疤痕子宫的产妇245例,并将其中再次剖宫产(RCS)143例与随机抽取同期首次剖宫产(PCS)143例进行对照;将其中疤痕子宫阴道分娩(VBAC)102例与随机抽取同期非疤痕子宫阴道分娩(VBNC)102例进行对照。结果 VBAC组与VBNC组的产程时间、产时出血量、新生儿窒息等指标比较差异均无统计学意义。RCS组与PCS组的手术时间、术中出血量、术后血红蛋白、子宫收缩法力、子宫切口愈合欠佳、腹腔粘连等指标比较差异均有统计学意义(P<0.05),脏器损伤、新生儿窒息比较差异无统计学意义。结论疤痕子宫符合条件者可阴道试产,阴道试产是安全可行的,对提高产科质量、减少母婴并发症具有重要意义。

Objective Discussion on the safety of pregnancy in scar uterus again. Methods Full-term pregnancy with uterine scar in 245 parturients were be collected from 2013 April to 2014 October, contrasting the repeat cesarean section （RCS） of 143 cases with the primary cesarean section （PCS） of 143 cases randomly selected over the same period,contrasting the vaginal birth after cesarean（VBAC） of 102 cases with the vaginal birth never cesarean（VBNC） of 102 cases randomly selected over the same period. Results Comparing VBAC group and VBNC group,there were no statistical significance in the time of birth process,the amount of bleeding of childbirth and neonatal asphyxia. Comparing RCS group and PCS group, operation time,the amount of bleeding during operation,postoperative hemoglobin,uterine atony,poor healing of uterus incision and peritoneal adhesion were statistically significant,there were no significant difference in organ injury and neonatal asphyxia. Conclusion Uterine scar in accordance with the conditions can be vaginal delivery,vaginal delivery is safe and feasible,it has the vital significance to improve the quality of Obstetrics and to reduce the complications of mothers and infants.