B超监测在剖宫产术后再次妊娠者阴道分娩中的应用及对产程的影响

Application of B-mode ultrasound in monitoring of vaginal delivery of subsequent pregnancy after cesarean section and the effect on stages of labor

目的探讨B超监测在剖宫产后再次妊娠患者阴道分娩中的应用效果及对产程的影响。方法选取2015年6月-2017年5月该院收治的剖宫产后再次妊娠阴道分娩患者90例,采用随机数字法分为对照组(45例)和观察组(45例)。对照组剖宫产后再次妊娠采用常规阴道分娩,观察组剖宫产后再次妊娠阴道分娩中采用B超监测,记录两组分娩方式、产前助产及分娩并发症发生情况,比较两组分娩效果及对产程的影响。结果观察组阴道分娩成功率高于对照组(P<0.05);观察组产钳助产率、剖宫产率均低于对照组(P<0.05);观察组阴道分娩第一产程、第二产程、第三产程及总产程时间与对照组比较,差异均无统计学意义(均P>0.05);观察组阴道分娩母婴并发症发生率为4.44%,与对照组22.22%比较,差异有统计学意义(P<0.05)。结论将B超用于剖宫产术后再次妊娠者阴道分娩中效果理想,有助于降低分娩并发症的发生率,但是不会对产程产生影响。

Objective To explore the application effect of B-mode ultrasound in monitoring of vaginal delivery of subsequent pregnancy after cesarean section and the effect on stages of labor. Methods From June 2015 to May 2017,90 patients of subsequent pregnancy after cesarean section undergoing vaginal delivery were selected and randomly divided into control group and observation group,45 patients in each group. The patients in control group underwent routine vaginal delivery,while the patients in observation group were monitored by B-mode ultrasound in labor. The delivery modes,prenatal midwifery,and delivery complications in the two groups were recorded. The delivery outcomes and the effects on stages of labor in the two groups were compared. Results The successful rate of vaginal delivery in observation group was statistically significantly higher than that in control group（P〈0. 05）. The rates of forceps delivery and cesarean section in observation group were statistically significantly lower than those in control group（P〈0. 05）. There was no statistically significant difference in the time of the first,the second,the third stages of labor,and the time of total stage of labor between the two groups（P〈0. 05）. The incidence rates of maternal and neonatal complications in observation group and control group were 4. 44% and 22. 22%,respectively,there was statistically significant difference between the two groups（P〈0. 05）. Conclusion The effect of B-mode ultrasound in monitoring of vaginal delivery of subsequent pregnancy after cesarean section is ideal,which can reduce the incidence rate of labor complications,but it has no impact on labor process.