剖宫产后疤痕子宫再次妊娠分娩方式的临床分析

Clinical Analysis of Once Again Delivery of Uterine Scar Uterus after Cesarean Section

目的分析剖宫产疤痕子宫再次妊娠的分娩结局,探讨疤痕子宫再次妊娠分娩方式的合理选择。方法以2016年1—6月该院产科229例剖宫产疤痕子宫再次妊娠患者为研究对象,全部患者均根据分娩指征予以剖宫产或阴道试产。回顾性分析患者临床资料,统计剖宫产率及阴道试产率,观察患者产时出血量、产后住院时间、并发症发生率及新生儿Apgar评分。结果 229例剖宫产疤痕子宫患者中,选择剖宫产手术216例(94.32%),阴道试产13例(5.68%)。剖宫产手术成功216例(100.00%),产褥感染3.24%,产后出血2.31%,新生儿Apgar 7~10分210例(97.22%)。阴道试产患者中,试产成功10例(76.92%),改行剖宫产3例(23.08%),并发症发生率0.00%,新生儿Apgar 7~10分12例(92.31%)。结论剖宫产手术是剖宫产后疤痕子宫再次妊娠患者分娩的主要方式,切实可行。但在严格把握阴道分娩指征、加强产程监测的基础上,予以剖宫产后疤痕子宫患者经阴道分娩也安全可靠,对降低剖宫产率具有积极作用,值得临床推广研究。

Objective This paper tries to analyze the outcome of the birth of uterine scar in cesarean section once again,and to explore the reasonable choice of the way of delivery of scar uterus. Methods 229 cases of cesarean section in this hospital from January to June 2016 were selected, and all patients were given cesarean section or vaginal production according to the indications of childbirth. The clinical data were retrospectively analyzed, cesarean section rate and vaginal trial rate were concluded, and the patients' bleeding volume, postpartum hospitalization time, complication rate and neonatal Apgar score were observed. Results Among the 229 cases of uterine scar uterus after cesarean section, 216 cases chose cesarean section(94.32%), 13 cases of vaginal production(5.68%); 216 cases(100.00%) of successful cesarean section, 3.24%of puerperal infection, 2.31% of postpartum hemorrhage, 210 cases(97.22%) of neonatal Apgar between 7 to 10 points. In vaginal trial production, 10 cases were successfully produced(76.92%), 3 cases(23.08%) of cesarean section, complication rate 0.00%, 12 cases(92.31%) of neonatal Apgar between 7 to 10 points. Conclusion Cesarean section operation is the main way of childbirth in the patients with scar uterus after cesarean section and is practicable. However, on the basis of strictly grasping the indications of vaginal confinement and strengthening the monitoring of labor, it is safe and reliable to give birth to scar uterus after cesarean section, which has a positive effect on reducing cesarean section rate and is worthy of clinical popularization.