疤痕子宫再次妊娠经阴道分娩的安全性探讨

Discussion on the Safety of Vaginal Delivery of Second Pregnancy with Scar Uterus

目的探讨疤痕子宫再次妊娠经阴道分娩的安全性。方法选取我院收治的130例子宫下段剖宫产疤痕子宫产妇,分为研究组与对照组各65例。研究组产妇经阴道分娩,对照组产妇经剖宫产分娩,比较两组的产后并发症发生率、住院时间、住院费用、产后出血量,分析子宫疤痕厚度对阴道分娩成功率的影响。结果研究组的产后并发症发生率为3.08%,显著低于对照组的12.31%(P<0.05)。研究组的产后出血量、住院时间、住院费用等均显著优于对照组,差异均有统计学意义(P<0.05)。研究组产妇中,不同子宫疤痕厚度的阴道分娩成功率比较,差异无统计学意义(P>0.05)。结论疤痕子宫再次妊娠产妇经严格评估,在严格产程监护的条件下采取阴道分娩,安全性较高,产妇的并发症发生率较剖宫产少,住院时间、住院费用均较低。

Objective To explore the safety of vaginal delivery of second pregnancy with scar uterus. Methods 130 cases of parturient women with caesarean scar in low uterine segment were selected and divided into two groups, with 65 cases in each group. The control group received cesarean section delivery, while the study group received vaginal delivery. The incidence of postpartum complications, length of hospital stay, hospitalization cost and postpartum hemorrhage volume were compared between two groups, and the impact of thickness of uterine scar on the success rate of vaginal delivery was analyzed. Results The incidence of postpartum complications of study group was 3.08%, significantly lower than 12.31% of control group （P 〈0.05）. The postpartum hemorrhage volume of study group was less than that of control group, the length of hospital stay was significantly shorter than that of control group, and the hospitalization cost was significantly lower than that of control group （P 〈0.05）. Among parturient women in study group, no statistical difference was found in the success rate of vaginal delivery among parturient women with different thickness of uterine scar （P〉0.05）. Conclusions Vaginal delivery with strict evaluation and labor monitoring in parturient women with second pregnancy with scar uterus has relatively high safety, with lower incidence of complications ofpuerperae, shorter length of hospital stay and lower hospitalization cost compared with cesarean section delivery.