瘢痕子宫再次妊娠选择不同分娩方式的临床对比

Clinical comparison of different delivery methods for uterine scar pregnancy

目的分析瘢痕子宫再次妊娠不同分娩方式的临床效果。方法选择2013年6月～2015年1月我院产科收治的120例瘢痕子宫再次妊娠孕妇为研究对象，根据分娩方式不同分为瘢痕子宫阴道分娩组和剖宫产组各60例，同时选择50例非瘢痕子宫阴道分娩产妇为非瘢痕子宫阴道组，比较分析各组产妇分娩情况以及新生儿Apgar评分情况。结果120例瘢痕妊娠产妇中，有48例择期行剖宫产手术；72例行引导试产，产程中采取急症剖宫产12例，60例阴道分娩成功，试产成功率为83．33％（60／72）。瘢痕子宫阴道分娩组与剖宫产组出血量分别为（212．57±25．88）ml和（398．67±33．43）ml，住院天数分别为（3．47±0．58）d和（5．99±0．61）d，产褥病发病率分别为6．67％和26．67％，差异均有统计学意义（P〈0．05）；两组新生儿Apgar评分差异无统计学意义（P〉0．05）。瘢痕子宫阴道分娩组与非瘢痕子宫阻道分娩组出血量分别为（212．57±25．88）m1和（209．47±13．48）ml，住院天数分别为（3．47±0．58）d和（3．37±0．46）d（P〉0．05），产褥病发病率分别为6．67％和6．00％（P〉0．05），两组新生儿Apgar评分差异无统计学意义（P〉0．05）。结论瘢痕子宫再次妊娠在产妇条件允许情况下，选择经阴道分娩能显著降低出血量、住院时间以及产褥病发病率．但对新生儿Apgar评分无较为显著的影响。

Objective To analyze the clinical effect of different delivery methods of scar uterus.Methods 120 cases of uterine scar pregnancy in our department of obstetrics from June 2013 to January 2015 were selected and divided into vaginal delivery group and cesarean section group according to the different delivery mode,with 60 cases in each group, and 50 cases of non scar uterus vaginal delivery women were as non scar uterus vaginal delivery group.Delivery of maternal and neonatal Apgar score were compared in two groups.Results In 120 patients with cesarean scar pregnancy matemat,48 cases elected cesarean section and 72 cases were lead to trial.12 cases in 72 cases were taken emergency cesarean section,and a total of 60 cases of vaginal delivery was successful,and trial production success rate was 83.33% （60/72）.In scar uterus vaginal delivery group and cesarean section group,the amount of bleeding was respectively （212.57±25.88） ml and （398.67±33.43）ml,the length of hospital stay was respectively （3.47±0.58） d and （5.99±0.61） d, puerperal disease incidence rate with 6.67% and 26.67%,all of the above results were statistically significant （P〈0.05） and neonatal Apgar scores of two groups were no significant difference （P〉0.05）;In scar uterus vaginal delivery group and non scar uterus vaginal delivery group,amount of bleeding was respectively （212.57 ±25.88 ）ml and （78.4±13.48） ml,hospitalized days was respectively （3.47±0.58） d and （3.37±0.46） d （P〉0.05）,puerperal disease incidence rates was respectively 6.67% and 6.00% （P〉0.05）,neonatal Apgar scores of two groups were no significant difference （P〉0.05）. Conclusion Uterine scar pregnancy in maternal condition permits,the vaginal delivery chosen can significantly reduce the amount of bleeding,hospitalization time and puerperal disease incidence,but neonatal Apgar scores has no more significantly effect.