剖宫产后瘢痕子宫再次妊娠经阴道分娩的母婴结局

Vaginal delivery outcomes of scar uterine pregnancy again after cesarean section

目的:探究与分析剖宫产后瘢痕子宫再次妊娠经阴道分娩的母婴结局。方法:回顾性分析我院自2015年6月至2016年6月收治的90例无产科合并症的剖宫产后瘢痕子宫再次妊娠产妇的临床资料,根据产妇检查结果与其意愿分为阴道分娩组(n=43)与剖宫产组(n=47),对比两组产妇产后24h出血量、新生儿体重、新生儿Apgar评分、平均住院时间、新生儿并发症。结果:阴道分娩组与剖宫产组相比,新生儿体重低,新生儿1min Apgar评分高,新生儿肺炎发生率低,差异具有统计学意义(P<0.05)。阴道分娩组与剖宫产组相比产后24h出血量少、住院时间较短,差异具有统计学意义(P<0.05)。两组产褥病发生率比较,差异无统计学意义(P>0.05)。结论:瘢痕子宫再次妊娠选择阴道分娩相比于剖宫产更具有临床优势,在瘢痕子宫妊娠产妇符合适应症的前提下,应鼓励首选阴道分娩。

Objectives： To probe and analyze the maternal and neonatal outcomes of scar uterine pregnancy again after cesarean section. Methods： A retrospective analysis of the clinical data of 90 patients with scar uterine pregnancy again after cesarean section treated in our hospital from June 2015 to June 2016 was done. According to the test results and the willingness,they were divided into vaginal delivery group（ n = 43） and cesarean section group（ n = 47）. The 24 hours＇ postpartum blood loss,birth weight and neonatal Apgar score,the average length of hospital stay and neonatal complications of two groups were compared. Results： Compared to cesarean section group,vaginal delivery group had lower neonatal birth weight,higher Apgar score and lower incidence of neonatal pneumonia,with statistically significant difference（ P 0. 05）. Compared to cesarean section group,vaginal delivery group had less postpartum blood loss,shorter hospital stay and less puerperal disease rate,with statistically significant difference（ P 0. 05）. Conclusion： Compared with cesarean section,vaginal delivery of scar uterine pregnancy again has more clinical advantages. On the premise of scar uterus pregnancy in line with the indication,vaginal delivery should be encouraged.