瘢痕子宫足月分娩方式及妊娠结局的临床分析

Clinical analysis of the delivery modes and pregnancy outcomes of pregnant women with cicatricial uterus

目的 研究瘢痕子宫足月分娩方式及妊娠结局。方法 选取2013年3月~2016年3月我院接诊的瘢痕子宫足月妊娠产妇作为研究组进行研究,并选择同期接诊的80例非瘢痕子宫妊娠剖宫产产妇作为对照组进行对比分析。比较分析两组产妇的分娩方式及妊娠结局状况。结果 80例瘢痕子宫患者中,71例患者行剖宫产,占88.75%,9例患者行阴道试产,占11.25%;71例剖宫产患者中,26例患者不具有阴道试产指征,占32.50%,45例患者因家庭及个人意愿等因素行剖宫产,占56.24%;阴道试产的9例患者中,7例成功,2例转为剖宫产手术。研究组患者的术中出血量明显多于对照组（P〈0.01）,分娩时间、住院时间明显长于对照组,差异有统计学意义（P〈0.01）。两组新生儿Apgar评分差异无统计学意义（P〉0.05）。研究组患者中产后出血（8.75%）、切口愈合不良（11.25%）、新生儿窒息（8.75%）及产褥病（12.50%）的发生率均明显高于对照组（1.25%、2.50%、1.25%、3.75%）,差异有统计学意义（P〈0.05）。结论 瘢痕子宫足月妊娠产妇可考虑行阴道试产,再次剖宫产的妊娠结局较差,有阴道试产指征的产妇可考虑顺产。

Objective To study the delivery modes and pregnancy outcomes of pregnant women with cicatricial uterus. Methods 80 cases of pregnant women with cicatricial uterus treated in our hospital from March 2013 to March 2016 were selected as the research group.Simultaneously,80 cases without cicatricial uterus who had undergone cesarean section were selected as the control group.A comparative analysis was carried out between the two groups in delivery modes and pregnancy outcomes.Results Of the 80 patients with cicatricial uterus,71 cases underwent cesarean section, accounting for 88.75%,9 cases underwent vaginal delivery,accounted for 11.25%;of the 71 cases undergoing cesarean section,26 cases did not meet with the indications of vaginal delivery,accounted for 32.50%,45 cases received cesarean section out of the will of patients or their family members,accounting for 56.24%;of the 9 cases of vaginal delivery, 7 cases were successful,2 cases were transferred to cesarean section.The amount of bleeding in the research group was significantly more than that in the control group （P〈O.O1）,and their delivery time and hospitalization periods were sig- nificantly shorter than those of the control group （P〈0.O1）.There was no significant difference in Apgar scores between the two groups （P〉0.05）.Patients in the research group had an obviously higher percentage of occurrence in postpartum hemorrhage （8.75%）,poor wound healing （ll.25%）,neonatal asphyxia （8.75%） and the puerperal disease （12.50%） than the patients in the control group （1.25%,2.50%,l.25%,3.75%）,and the differences were statistically significant （P〈O.05）. Conclusion Vaginal delivery can be an option for pregnant women with cicatricial uterus.The pregnancy outcomes of reconsidered cesarean section cannot be satisfactory.Natural delivery can be considered for pregnant women with indi- cations of vaginal delivery.