剖宫产术后瘢痕子宫再次妊娠经阴道分娩的可行性及安全性研究

Feasibility and safety research on vaginal delivery in re-pregnancy by scarred uterus after cesarean section

目的探究瘢痕子宫再次妊娠经阴道分娩的可行性及安全性。方法选取2016年10月~2017年2月我院收治的瘢痕子宫再次妊娠并自愿接受阴道试产产妇62例作为观察组,选择同期我院收治的符合阴道分娩条件的经产妇(第一胎自然分娩)60例作为对照组,比较两组的阴道分娩成功率、产程时间、产后出血量、住院时间以及新生儿Apgar评分、产妇产后并发症发生情况。结果观察组和对照组中均有49例产妇经阴道成功分娩,阴道分娩的成功率分别为79.03%和81.67%,两组比较差异无统计学意义(P>0.05);两组产妇产程时间、产后出血量、住院时间及新生儿Apgar评分比较,差异无统计学意义(P>0.05);两组产妇产后并发症发生情况比较,差异无统计学意义(P>0.05)。结论只要在产前做好充分的评估及应急预案措施,并严格掌握阴道分娩的指征,瘢痕子宫产妇选择阴道分娩方式是可行的。

Objective To explore the feasibility and safety of vaginal delivery in re-pregnancy by scarred uterus.Methods Sixty-two puerperae in re-pregnancy by scarred uterus who were willing to accept vaginal delivery from October 2016 to February 2017 in our hospital were selected as observation group.Sixty pluriparae （natural labor in the first pregnan- cies） meeting the criteria of vaginal delivery admitted into our hospital during the same period were classified into con- trol group.The success rate of vaginal delivery,stage of labor,postpartum hemorrhage,hospital stay,score of neonatal Ap- gar,and incidence of postpartum complications in puerperae were compared in the two groups.Results There were 49 puerperae succeeding in vaginal delivery in both observation group and control group,the success rate of vaginal deliv- ery was 79.03% and 81.67% respectively,without statistically significant difference （P〉0.05）.There was no significant difference in stage of labor,postpartum hemorrhage,hospital stay or score of neonatal Apgar （P〉0.05）.There was no sta- tistically significant difference in postpartum complications detected in the two groups （P〉0.05）.Conclusion As long as sufficient assessment and emergency plan and measures be prepared before delivery,together with strict control of vagi- nal delivery indications,vaginal delivery is still feasible in puerperae with scarred uterus.