剖宫产术后再次妊娠分娩方式的临床分析

Clinical analysis of delivery mode of post-cesarean section re-pregnancy

目的探讨剖宫产术后再次妊娠分娩方式的选择及对妊娠结局的影响。方法收集山西医科大学第一附属医院产科2014年2月~2015年10月收治的剖宫产术后再次妊娠经阴道分娩孕妇68例(A组),选择同期非瘢痕子宫经阴道分娩孕妇68例(B组)及剖宫产术后再次妊娠行择期剖宫产术孕妇68例(C组)。比较分析各组孕妇的分娩结局、母婴并发症等情况。结果 A组与B组住院时间、产后出血量、总产程、助产率、产后发热率、新生儿窒息率比较,差异无统计学意义(P>0.05);C组产妇胎盘娩出时间少于A组,产后出血量多于A组,住院时间长于A组,差异有统计学意义(P<0.05)。结论在严密监测产程且严格掌握阴道分娩指征的前提下,剖宫产后再次妊娠者选择经阴道分娩并不会增加母婴不良妊娠结局的发生。

Objective To investigate the selection of delivery mode and its influence on the outcome of post-cesarean section re-pregnancy.Methods Puerperas who were hospitalized in the First Affiliated Hospital of Shanxi Medical University from February 2014 to October 2015 were selected：68 pregnant women of re-pregnancy vaginal delivery after cesarean section（group A）,68 pregnant women of non-scar uterus vaginal delivery（group B）,68 pregnant women of re-pregnancy elective cesarean section after cesarean section in the same period（group C）.The delivery outcomes,complications of maternal and children between each group was analyzed and compared.Results The hospitalization time,postpartum hemorrhage volume,total stage of labor,delivery rate,rate of postpartum fever,rate of neonatal asphyxia in the group A and group B had no statistically significant difference（P〈0.05）;the time of placental expulsion in the group C was less than that of the group A,the postpartum hemorrhage volume of the group C was more than that of group A,the hospitalization time of group C was longer than that of the group A,the differences were statistically significant（P 0.05）.Conclusion Under the premise of close monitoring of the labor stage and strict control of the indications of vaginal delivery,selection of the vaginal delivery for post-cesarean section re-pregnancy will not increase the incidence of adverse pregnancy outcomes.