剖宫产术后再次妊娠分娩方式的临床分析

Clinical analysis of re-pregnant woman after caesarean birth for delivery way

目的：分析剖宫产术后再次妊娠的分娩方式。方法回顾性分析2009年1月1日~2012年12月31日本院收治的68例剖宫产术后再次妊娠分娩产妇的临床资料，30例选择阴道试产（VBAC组），38例实施再次剖宫产（RCS组），比较两种不同分娩方式后两组产妇的产后出血量、产后感染率、新生儿体重、新生儿5 min Apgar 评分、住院时间等指标。结果 VBAC组的产后出血量、产后感染率、住院时间、新生儿呼吸系统并发症发生率、住院费用、护理满意度、腹腔粘连率、切口甲级愈合率及出院时产妇恢复良好率均显著低于RCS组，差异有统计学意义（P〈0.05），但两组的新生儿感染率、体重及5 min Apgar评分差异无统计学意义（P〉0.05）。结论剖宫产术后再次妊娠的孕妇无剖宫产指征并符合阴道试产条件，应优先选择阴道试产，可提高妊娠结局的安全性。

Objective To study the delivery way of the re-pregnant woman after caesarean birth. Methods The clinical data of 68 cases of delivery in women of secondary pregnancy after cesarean from January 1,2009 to December 31, 2012 in our hospital were analysed,30 women were applied vaginal delivery （VBAC group）,38 women were applied re-peated cesarean section（RCS group）.After the two different delivery way,the postpartum hemorrhage quantity,postpartum infection rate, neonatal birth weight and 5 min Apgar scoreof,hospitalization time between the two groups were com-pared. Results Postpartum hemorrhage quantity,postpartum infection rate,hospitalization time,the incidence of neonatal respiratory complications,hospital fees,nursing satisfaction,abdominal cavity adhesion rate,incision healing rate,maternal good recovery rate in VBAC group significantly lower than those of RCS group,the difference was significant （P〈0.05）. Neonatal infection rates, the index of neonatal weight and 5 min Apgar score between two groups had no significant dif-ference （P〉0.05）. Conclusion Pregnant women with pregnancy cesarean section again after cesarean section should be the preferred option of vaginal delivery,in the case of vaginal delivery indications and no indications for cesarean sec-tion,can improve the safety of pregnancy outcome.