延期妊娠引产后剖宫产的危险因素分析

Analysis of Risk Factors for Cesarean Section after Induction of Late-term Pregnancy

目的探讨延期妊娠初产妇引产后剖宫产的危险因素。方法选择我院2010年12月至2016年12月因延期妊娠住院要求引产的单胎头位初产妇275例,其中80例引产后行剖宫产的患者为剖宫产组,195例同期引产后正常阴道分娩的患者为阴道分娩组。采集临床资料进行回顾性分析,通过单因素分析和二项分类logistic回归分析,确定延期妊娠引产后剖宫产的独立危险因素。结果单因素分析显示,2组患者的身高、引产前宫颈Bishop评分、潜伏期时间、产时人工破膜、产时催产素应用、羊水粪染、新生儿体质量的差异均有统计学意义(P<0.05)。多因素分析发现,孕妇身高、引产前宫颈Bishop评分、潜伏期时间为延期妊娠引产后剖宫产的独立危险因素。结论身高矮、引产前Bishop评分低或潜伏期时间长的延期妊娠孕妇引产,需做好母儿综合评估,合理选择分娩方式,避免不良结局的发生。

Objective To explore the risk factors for cesarean section after induction of late-term pregnancy. Methods This study enrolled 275 primiparas with a single cephalic fetal presentation, admitted to our hospital between December 2010 and December 2016 for induction of late-term pregnancy. After induction, 80 underwent cesarean section and 195 had a normal vaginal delivery. Clinical data were collected and analyzed retrospectively. Single factor analysis and two categories of logistic regression analysis were used to determine the independent risk factors for cesarean section after induction of late-term pregnancy. Results Single factor analysis showed that the differences between the two groups in maternal height, cervical Bishop score before induction of labor, latent phase, intrapartum amnioto- my,intrapartum oxytocin,meconium stained amniotic fluid,and birth weight were statistically significant （P 〈 0.05）. Multivariate analysis showed that maternal height, cervical Bishop score before induction of labor, and latent phase were independent risk factors for cesarean section after induction of late-term pregnancy. Conclusion Late-term pregnant primiparas with short stature,low Bishop score, or a long latent phase should have comprehensive prenatal maternal-fetal assessment, and a reasonable delivery mode should be chosen to avoid adverse outcomes.