瘢痕子宫再次妊娠经阴道分娩的临床效果及安全性研究

Clinical Effect and Safety of Scarred Uterus Re-pregnancy by Vaginal Delivery

目的探讨瘢痕子宫再次妊娠经阴道分娩的临床效果及安全性。方法回顾性分析2014年2月—2016年8月成都市妇女儿童中心医院收治的136例瘢痕子宫再次妊娠经阴道试产产妇的临床资料,根据分娩方式不同分为剖宫产组27例和经阴道分娩组109例,并选取同期收治的非瘢痕子宫再次妊娠经阴道分娩产妇70例为对照组,观察并比较3组产妇产后出血量、住院时间、住院费用、新生儿窒息及并发症发生情况。结果经阴道分娩组及对照组产后出血量、住院时间、住院费用及并发症发生率均低于剖宫产组(P<0.05);3组新生儿Apgar评分和窒息发生率比较,差异无统计学意义(P>0.05)。结论瘢痕子宫再次妊娠经阴道分娩能够缩短住院时间,减少出血量和并发症的发生,对母婴结局无明显影响,安全性较高,值得推广应用。

Objective To explore the clinical effect and safety of scarred uterus re-pregnancy by vaginal delivery.Methods One hundred and thirty-six puerperas of scarred uterus re-pregnancy by vaginal delivery in Chengdu Women’s and Children’s Central Hospital from February 2014 to August 2016 were retrospective analysis,divided into cesarean delivery group（ 27 cases） and vaginal delivery group（ 109 cases） according to different delivery methods,and 70 puerperas of non scarred uterus re-pregnancy by vaginal delivery during the same period as control group, postpartum blood loss, length of stay,Hospitalization expenses,neonatal asphyxia and complications among three groups were compared. Results Postpartum blood loss,length of stay,Hospitalization expenses,and incidence rate of complication in vaginal delivery group and control group were lower than those in cesarean section group（ P 〈 0. 05）. The incidence of neonatal asphyxia and Apgar score among three groups were no statistical significance（ P 〉 0. 05）. Conclusion Scarred uterus re-pregnancy by vaginal delivery can shorten the length of hospital stay,reduce the bleeding and complications,and had no obvious effect on maternal and infant outcomes,high security,is worthy of popularization and application.