疤痕子宫再次妊娠阴道分娩的临床结局及可行性分析

Clinical observation and analysis of 53 cases of scar repregnancy with vaginal delivery

目的:探讨疤痕子宫再次妊娠经阴道分娩的可行性和安全性。方法:回顾分析2014年1月至2015年6月本院产科458例疤痕子宫再次妊娠分娩的临床资料。其中53例患者选择了经阴道分娩(观察组),随机选择疤痕子宫再妊娠后行剖宫产53例作为对照组,比较两组临床结局和母儿预后。结果:与对照组相比,观察组产时出血量较少(t=25.393,P=0.000)、住院时间短(t=4.358,P=0.039),产妇产后出血减少(χ2=3.975,P=0.046)、产褥感染发生率较低(χ2=6.360,P=0.012),差异均具有统计学意义。观察组与对照组比较,新生儿Apgar评分、新生儿体重、新生儿湿肺发生率无显著差异(t=2.971,P=0.088;t=3.756,P=0.055;χ2=3.087,P=0.079)。结论:在严格掌握适应症的前提下,疤痕子宫再次妊娠经阴道分娩是可行的,有利于产后恢复。

Objective： To investigate feasibility and safety of scar term pregnancy with vaginal delivery. Methods： Retrospectively analyze 458 cases clinical data of scar repregnancy with vaginal delivery from January 2014 to June 2015 in which 53 patients chose vaginal delivery,as observation group,comparatively analyze 53 random cases（ control group） of scar uterine cesarean section.The prognosis of two groups was compared. Results： Compared with the control group,the bleeding volume in observation group was reduced,shorter hospitalization time,maternal postpartum disease rate,endometritis,cureless incision rate was reduced,The difference was statistically significant（ t = 25. 393,P = 0. 000; t = 4. 358,P = 0. 039; χ2= 3. 975,P = 0. 046; χ2= 6. 360,P = 0. 012）. Compared with the control group the neonatal Apgar score,neonatal weight and neonatal wet lung had no statistical significance（ t = 2. 971,P =0. 088; t = 3. 756,P = 0. 055; χ2= 3. 087,P = 0. 079）. Conclusion： Scar repregnancy with vaginal delivery in strict control of indications is feasible and conducive to postpartum recovery.