瘢痕子宫再次妊娠行阴道分娩的可行性以及安全性研究

目的探讨瘢痕子宫再次妊娠分娩行阴道试产的可行性与安全性。方法选取瘢痕子宫再次妊娠选择行阴道分娩产妇120例作为观察组,符合瘢痕子宫产妇试行阴道分娩条件。并随机选取同期的非瘢痕子宫选择阴道分娩产妇120例为对照组。比较2组产妇经阴道分娩成功率、产程时间、产程中出血量、产后并发症以及新生儿情况(出生Apgar评分、体质量)。结果观察组经阴道分娩成功率61.67%(74/120)显著低于对照组82.50%(99/120),差异有统计学意义(P<0.05)。观察组与对照组产妇的产程时间[(8.60±0.75)h vs(8.56±0.61)h]、术中出血量[(160.45±17.20)m L vs(163.35±12.50)m L]、新生儿出生Apgar评分[(8.20±0.35)分vs(8.10±0.20)分]、住院时间[(4.65±1.35)d vs(4.50±1.95)d]以及产后并发症发生率[17.50%(21/120)vs 12.50%(15/120)]比较,差异均无统计学意义。结论对符合阴道分娩试产条件的瘢痕子宫再次妊娠采用阴道试产是可行的,降低了再次剖宫产率,对母婴结局无明显影响。

Objective To discuss the feasibility and safety of uterine scar pregnancy again by vaginal delivery. Methods A total of 120 cases of uterine scar pregnancy again by vaginal delivery were treated as the observation group, which in line with the maternal uterine scar trial vaginal delivery conditions. And randomly choose the same period of the non-scarred uterus vaginal delivery of maternal 120 cases of the control group.The maternal vaginal delivery success rate, duration of labor, labor in the amount of bleeding, postpartum complications, and newborns （birth Apgar score, body mass） were compared between the two groups. Results The vaginal delivery success rate （61.67%, 74/120） in observer group was significantly lower than the control group （82.50%, 99/120）, the difference was statistically significant （P〈0.05）. But the observation group and the control group of mothers of labor time was （8.60±0.75） h vs （8.56±0.61） h, blood loss（160.45±17.20） rnL vs （163.35±12.50） mL, birth Apgar score （8.20±0.35） vs （8.10-±0.20）, length of hospital stay （4.65±1.35） d vs （4.50±1.95） d and postpartum complications[17.50% （21/120） vs 12.50% （15/120） ], the difference was not statistically significant. Conclusion To comply with vaginal delivery trial production conditions uterine scar pregnancy again using vaginal trial production is feasible to reduce the cesarean section rate, no significant effect on maternal and neonatal outcomes.