“二胎政策”下剖宫产妇女再次妊娠意愿及适宜分娩方式分析

Analysis of Second Pregnancy Willingness and Appropriate Delivery Mode in Women with Cesarean Delivery Under the “Two-Child Policy”

目的探讨和分析"二胎政策"下剖宫产妇女再次妊娠意愿及再次适宜分娩方式。方法在2015年1月-2016年6月期间,调查来我院进行孕前检查938例孕妇在二胎政策下再次妊娠的意愿,研究305例剖宫产妇再次妊娠的分娩方式和妊娠结局。结果在938例孕妇中,有196例妇女上次分娩的方式为剖宫产,有121例(121/196,61.73%)妇女有再次妊娠的意愿,其中有84例妇女(84/121,69.42%)是因为二胎政策才有的再次妊娠意愿。在305例剖宫产妇再次妊娠中,顺产的新生儿阿氏评分、产后2h出血量、新生儿体质量、住院时间、产后发热情况均优于剖宫产,差异对比存在统计学意义(P<0.05)。顺产的新生儿窒息情况、产后出血情况与剖宫产相比较,差异均不存在统计学意义(P>0.05)。结论对剖宫产妇来说,具有再次妊娠意愿的主要原因是二胎政策,且再次妊娠经阴道分娩的临床指标情况、妊娠结局情况均要明显好于剖宫产。在熟练掌握阴道试产的指证情况下,是可进行阴道分娩的。

Objective To investigate and analyze the second pregnancy willingness and appropriate delivery mode in women with cesarean delivery under the ＂Two-Child Policy＂. Methods During January 2015 to June 2016, the second pregnancy wildness under the ＂Two-Child Policy＂ were investigate among the 938 cases of pregnant women for pregnancy check in our hospital. In the same period, the second delivery mode and outcome were observed and recorded among the 305 cases of cesarean delivery women..Reszzlts Among the 938 pregnant women, there were 196 women given cesarean delivery in the first pregnant, 121 women （121/196, 61.73%） had second pregnancy willingness and 69.42% （84/121） was because of two-child policy. Among the 305 cases of 305 cases of cesarean delivery women, the Apgar score, 2h postpartum hemorrhage, neonatal body mass, hospitalization time, postpartum fever of eutocia delivery were better than those of cesarean delivery, the difference had statistical significance （P〈0.05）. The neonatal asphyxia, postpartum hemorrhage were not statistically significant between eutocia deliver and cesarean delivery （P〉0.05）. Conclusion The ＂two-child policy＂ is the main reason for second pregnancy in women with cesarean delivery. The clinical indicators and pregnancy outcomes of vaginal delivery are much better than those of cesarean delivery. Vaginal delivery is feasible under the condition of vaginal trial production.