剖宫产术后再次妊娠阴道试产产妇母婴结局及相关因素分析

Analysis of maternal and infant outcome and related factors of pregnant women with vaginal delivery after cesarean section

目的分析剖宫产术后再次妊娠阴道试产产妇的母婴结局及影响因素。方法对116例剖宫产术后再次妊娠阴道试产产妇的临床资料进行回顾性研究，其中69例采用阴道试产成功产妇作为观察组，47例阴道试产失败进行剖宫产产妇作为对照组。对比两组产妇的临床资料以及母婴结局，并分析影响阴道试产成功的相关因素。结果观察组产妇出血量和产褥期感染发生率均显著低于对照组，组间差异有统计学意义（P〈0．05）；经过单因素分析和多因素Logistic回归分析显示，产妇阴道分娩史、分娩孕周、距离上次剖宫产时间以及预测新生儿体质量等均是影响剖宫产术后再次妊娠阴道试产成功率的独立因素（P〈0．05）。结论剖宫产术后再次妊娠产妇采用阴道试产有助于提高母婴结局，是理想的分娩方式。但影响阴道试产成功率的危险因素较多，临床上需对相关影响因素进行积极干预。提高阴道试产成功率。

Objective To analyze the maternal and infant outcome and influencing factors of pregnant women undergoing trial delivery of vaginal delivery after cesarean section. Methods A retro- spective study of 116 pregnant women who underwent cesarean section after pregnancy was performed in hospital. Among the 116 pregnant women, 69 pregnant women who underwent vaginal trial success were selected as the observation group and 47 pregnant women of vaginal trial delivery failure of cesarean sec- tion were selected as the control group. The clinical data of the maternal and maternal and infant out- comes were compared, and the factors that affected the success of vaginal trial production were analyzed. Results The bleeding volume and the incidence of puerperium infection in the observation group were significantly lower than those in the control group （P 〈 0. 05 ）. After univariate analysis and multivariate logistic regression analysis, the vaginal delivery history, vaginal delivery weeks, distance from cesarean section and prediction of newborn body weight were independent factors influencing the success rate of re- testing vaginal pregnancy after cesarean section （P 〈 0. 05 ）. Conclusions Vaginal trial of cesarean sec- tion after pregnancy in pregnant women with vaginal trial will help to improve the outcome of maternal and infants, it is an ideal mode of delivery of newborns. However, the risk factors influencing the success rate of vaginal trial production are more and more, and the relevant factors need to be actively intervened clin- ically to improve the success rate of vaginal trial production.