72例瘢痕子宫再次妊娠结局的分析

Analysis of 72 cases of uterine scar pregnacy

目的:探讨瘢痕子宫再次妊娠分娩方式的选择。方法:对72例剖宫产术后再次妊娠分娩孕妇的分娩方式、分娩结局等资料进行回顾性分析。结果:72例中阴道试产47例,试产成功36例(76.6%);再次剖宫产36例(50.0%),直接行剖宫产术占25例(34.7%),阴道分娩36例(50.0%)。阴道分娩组与再次剖宫产组对新生儿影响比较差异无统计学意义(P>0.05)。剖宫产产妇产褥感染、产后出血、住院时间比较,再次剖宫产组均较阴道分娩组高,差异有统计学意义(P<0.05)。结论:剖宫产术后再次妊娠选择阴道分娩方式(以下简称VBAC)值得提倡,但应严格掌握阴道试产的适应证及禁忌证,对阴道试产不成功者宜及时改为剖宫产。72例患者中,试产成功率为76.6%;直接行剖宫产术占34.7%。此方法可降低剖宫产率,避免远期并发症,提高分娩质量。

Objective： To investigate the pregnancies after cesarean section selection. Methods：On the mode of delivery in 72 cases pregnant women pregnancy after cesarean section, labor outcome data were retrospectively analyzed. Results： Of the 72 patients, the success patients of labor was 36 cases （76.6%）; again for cesarean section in 36 cases （50.0%）; cesarean delivery directly accouted for 25 cases （34.7%）; vaginal delivery in 36 cases （50.0%）; no statistical significance in vaginal delivery group and repeat cesarean section group influence on neonates compared differences （P〉0.05）. And cesarean section,postpartum hemorrhage, puerperal infection and hospitalization time comparison, cesarean section group compared with vaginal delivery group,the difference has statistical significance （P〈0.05）. Conclusion： Pregnancy after cesarean section vaginal delivery is worth advocating selection mode （to hereafter refer to as VBAC）. But should strictly control the indication and contraindication of vaginal delivey. For vaginal delivery inless successful learners should timely change for cesarean section.Of the 72 patients,the success rate of labor was 76.6%; cesacean delivery directly accouted for 34.7%. This method can reduce the rate of cesacean section ,avoid long-term complications, improve the quality of delivery.