剖宫产术后瘢痕子宫足月分娩结局的影响因素分析

Analysis of the Influence Factors on Full-term Delivery Outcome of Scar Uterus after Cesarean Section

目的探讨剖宫产术后瘢痕子宫足月分娩的方式选择及瘢痕子宫足月分娩对妊娠结局的影响。方法将2010年11月至2013年11月石柱县人民医院收治的103例剖宫产术后瘢痕子宫足月分娩产妇作为观察组,其中阴道分娩45例、再次剖宫产58例。另外选择同期常规妊娠的非瘢痕子宫足月分娩产妇作为对照组。比较阴道分娩组与再次剖宫产组的临床效果及瘢痕子宫对妊娠结局的影响。结果再次剖宫产组与阴道分娩组住院时间、出血量和Apgar评分比较差异均有统计学意义(P<0.01);两组盆腹腔粘连及产后发热方面的差异均有统计学意义(P<0.05或P<0.01);多元Logistic回归分析,剖宫产术后瘢痕子宫足月分娩影响妊娠结局的因素为:先兆子宫破裂及社会因素。结论剖宫产术后瘢痕子宫影响妊娠结局的因素较多,应对这些因素进行控制,以改善妊娠结局。

Objective To explore the choice of full-term delivery way with scar uterus after cesarean section and the influencing factors on the pregnancy outcome. Methods During Nov. 2010 and Nov. 2013 in Chongqing Shizhu People＇s Hospital,103 full-term pregnant women with scar uterus after cesarean section were included as observation group,including 45 cases of vaginal delivery,58 cases of cesarean section again. Other normal full-term pregnant women during the same period were included as control group. The clinical effect of vaginal delivery and cesarean section again group and the scar uterus influence on pregnancy outcome were compared and analyzed. Results The hospitalization time and blood loss of cesarean section again and vaginal delivery group had statistically significant difference（ P〈0. 01）. The basin celiac adhesion and postpartum fever differences had statistically significant difference（ P〈0. 05 or P〈0. 01）. Multivariate Logistic regression analysis showed the influencing factors of pregnancy outcomes of cesarean section scar uterus were： threatened uterine rupture,and social factors. Conclusion There are multiple factors affecting pregnancy outcome of patients with scar uterus after cesarean section,which should be controlled to improve the pregnancy outcome.