瘢痕子宫再次妊娠分娩方式选择及经阴道分娩安全性的临床分析

Selection of delivery mode of uterine re-pregnancy and clinical analysis of vaginal delivery safety

目的探讨瘢痕子宫再次妊娠分娩方式选择及经阴道分娩的安全性。方法选取2013年5月—2016年5月在我院住院且符合阴道分娩条件的164例瘢痕子宫再次妊娠患者为研究对象,选择阴道试产71例为A组,选择再次剖宫产分娩93例为B组;另选取同期初产阴道分娩80例为对照组(C组),比较3组产妇分娩结局。结果 A组阴道试产成功率77.46%,C组为88.75%,2组比较差异无统计学意义(P>0.05);A组阴道助产率9.86%,C组为1.25%,A组明显高于C组(P<0.05);A组试产成功产妇出血量、产程时间、住院时间及新生儿Apgar评分与C组比较差异均无统计学意义(P>0.05);A组出血量及住院时间均优于B组(P<0.01);A组产妇术后并发症发生率为4.23%,B组为15.05%,组间比较差异显著(P<0.05)。结论瘢痕子宫再次妊娠并不能作为剖宫产的必然适应证,在严格控制产妇适应证的基础上,应优先选择经阴道自然分娩。

Objective To explore selection of delivery mode of uterine re-pregnancy and the safty of vaginal delivery.Methods In May 2013-May 2016 in Suixi County Hospital of Anhui Province hospitalized and meet the vaginal delivery conditions of 164 cases of scar uterus pregnancy again were selected as the object of study,71 cases of vaginal trial were selected as group A,and 93 cases of group C were selected for cesarean delivery;Another 80 cases of vaginal delivery were selected as the control group（group C）,three groups ofmaternal childbirth outcome was compared. Results Vaginal trial production success rate of group A was 77.46%,group C was 88.75%,there was no significant difference between the two groups（P〉0.05）.The vaginal feeding rate of group A was 9.86%,group C was 1.25%,and group A was significantly higher than group C（P〈0.05）.There was no significant difference in successful maternal bleeding,labor time,hospitalization time and neonatal Apgar score in group Acompared with those in group C（P〉0.05）;Compared with group B,the bleedingvolume and hospital staywere better than group B（P〈0.01）.The incidence ofcomplication rate ofgroup Awas 4.23%,and group B was 15.05%,there was significant difference between the twogroups（P〈0.05）.Conclusion Scar uterine pregnancycan not be used as a cesarean section ofthe inevitable indications,in the strict control ofmaternal indications on the basis ofpriority,should be given the vaginalnaturalchildbirth.