剖宫产术后再次妊娠的分娩方式选择研究

Selection of Mode of Delivery for Subsequent Pregnancy after Cesarean Section

目的探讨和分析剖宫产术后再次妊娠选择不同的分娩方式对母婴的影响。方法整群选择该院2013年2月—2015年2月收治的瘢痕子宫患者258例,其中99例患者符合阴道试产条件并要求试产,试产成功的有47例,分为A组,试产不成功改为剖宫产的有52例,分为B组,其余进行再次择期剖宫产的159例为C组。比较A、B、C3组产后的各项指标。结果 A组与C组产褥病率、产后出血量、住院时间上相比,差异有统计学意义(P<0.05),在新生儿窒息率上相比,两组对比差异无统计学意义(P>0.05)。B组与C组在新生儿窒息率、产褥病率、产后出血量、住院时间上比较差异无统计学意义(P>0.05)。结论剖宫产术后再次妊娠选择阴道分娩在临床上是可行的,临床应根据产妇情况选择最佳分娩方式。

Objective To discuss and analyze the effect of selection of mode of delivery for subsequent pregnancy after ce-sarean section on the mother and child. Methods 258 cases with scarred uterus admitted in our hospital from February 2013 to February 2015 were selected. Of them, 159 cases underwent elective cesarean section were selected as group C, 99 cases met the conditions of vaginal delivery required vaginal delivery, and among the 99 cases, 47 cases with successful vaginal delivery were set as group A, the other 52 cases transferred to undergo elective cesarean section due to the failure of vaginal delivery were set as group B. And the values of postpartum indicators of the three groups were compared. Results The differences in the puerperal morbidity, postpartum hemorrhage and the hospital stay between group A and group C were statistically significant （P〈0.05）, but the difference was not statistically significant in the neonatal asphyxia rate between the two groups（P〉0.05）. The differences in the neonatal asphyxia rate, puerperal morbidity, postpartum hemorrhage and the hos-pital stay between group B and group C were not statistically significant （P〈0.05）. Conclusion Vaginal delivery is feasible for subsequent pregnancy after cesarean section in clinical practice. The best mode of delivery should be selected according to the maternal conditions.