首次剖宫产术后再次妊娠经阴道分娩的妊娠观察

Observation of Pregnancy Outcome on Vaginal Birth after Cesarean

目的分析首次剖宫产术后再次妊娠经阴道分娩的妊娠结局。方法选取2014年2月~2015年11月我院接收的首次剖宫产术后再次妊娠的产妇90例作为研究对象,将所有产妇按照随机数表法分为两组,各45例。对照组产妇在出现分娩指征后立刻实施剖宫产,观察组则实施阴道试产。对比两组产妇分娩情况、产褥期感染率及阴道试产成功率。结果观察组产妇总产程时间、产后出血量、住院时间均低于对照组,新生儿Apger评分高于对照组,差异显著(P<0.05),新生儿出生体重比较无显著差异(P>0.05);观察组产褥期感染率明显低于对照组,差异显著(P<0.05);阴道试产成功率为39例(86.67%)。结论首次剖宫产术后再次妊娠经阴道分娩具有一定可行性,但分娩前需全面评估产妇的具体症状,以减少分娩过程中出现的不良反应,降低术后并发症发生率,改善分娩结局。

Objective： To analyze the pregnancy outcome of vaginal birth after cesarean （VBAC）. Methods： Totally, 90 multiparae undergoing cesarean section were admitted and treated in our hospital from February 2014 to November 2015 as the objects of study. They were randomly divided into control group and test group with 45 multiparae in each group. Multiparae in control group underwent cesarean section, while multiparae in test group underwent vaginal birth. The condition of delivery, the infection rate ofpuerperium, and the success rate of vaginal delivery were compared between two groups. Results： The total labor duration, postpartum hemorrhage, and hospitalization time in test group were significantly lower than those in control group （P 〈 0.05）. （2） The Apger score in test group was significantly higher than that in control group （P 〈 0.05）. However, there was no significant difference in the birth weight of infant between two groups （P 〉 0.05）. （3） The infection rate of puerperium in test group was significantly lower than that in control group （P 〈 0.05）. （4） The successful rate of vaginal birth in test group was 86.67% （39/45）. Conclusions： Application of vaginal birth after cesarean has certain feasibility. Meanwhile, before delivery the specific symptoms should be completely assessed in order to reduce adverse reactions and postoperative complications, to improve pregnancy outcome.