剖宫产瘢痕子宫妇女再次妊娠阴道分娩效果探讨

Effect of Vaginal Delivery after Re-pregnancy in Cesarean Scar Scared Uterus

目的研究经剖宫产术后形成瘢痕子宫的妇女再次妊娠选择阴道分娩的可行性和安全性。方法回顾性方便选取该院妇产科2016年1月—2017年2月在该院妇产科分娩的瘢痕子宫再次妊娠孕产妇77例,按实际分娩方式分为再次剖宫产组和阴道分娩组,对比两组产妇分娩的临床效果,观察母婴结局。结果阴道分娩组出血量为(183.1±22.6)m L,新生儿体重为(3 071.0±109.4)g,剖宫产组分别为(253.1±52.6)m L,(3 279.3±184.6)g,对比差异有统计学意义(t=7.068,5.704,P<0.05)。阴道分娩组产褥感染率为3.1%,明显低于剖宫产组17.8%,差异有统计学意义(χ~2=3.889,P<0.05)。结论瘢痕子宫孕妇再次妊娠时若满足阴道分娩指征且掌握了阴道试产适应证及相关禁忌证时,阴道试产是其分娩方式的合理选择,效果明确,相对安全性较好,在临床工作上具有可行性。

Objective This paper tries to study the feasibility and safety of vaginal delivery for women who formed cicatricial uterus after cesarean section. Methods 77 cases of pregnant women with scar uterus who were delivered from January2016 to February 2017 in this hospital were convenient selected. They were divided into the second cesarean section group and the vaginal delivery group according to the actual delivery mode. The clinical effects of the two groups were compared,and the maternal and infant outcomes were observed. Results The amount of hemorrhage in the vaginal delivery group was（183.1±22.6）m L, and the neonatal weight was（3 071.0±109.4） g. The cesarean section group was（253.1±52.6） m L,（3 279.3±184.6） g, and the difference was statistically significant（t=7.068, 5.704, P〈0.05）. The prevalence of puerperal infection in the vaginal delivery group was 3.1%, which was significantly lower than that of the cesarean section group（17.8%）. The difference was statistically significant（χ2=3.889, P〈0.05）. Conclusion When the scar pregnant woman in the uterus meets the indication for vaginal delivery and grasps the vaginal trial production indications and related contraindications during pregnancy, the vaginal trial production is a reasonable choice for the mode of delivery, the effect is clear, the relative safety is better, and the clinical work is better with feasible application.