瘢痕子宫再次阴道分娩的安全性及分娩过程中子宫破裂的诊断分析

Safety of uterine cicatricial uterine vaginal delivery and diagnosis of rupture of uterus during delivery

目的探讨瘢痕子宫再次阴道分娩的安全性以及分娩过程中子宫破裂的诊断方法。方法通过选自于2015年1月—2016年12月期间在我院进行分娩的瘢痕子宫再次妊娠70名产妇作为本次研究对象的观察组,与此同时选自同阶段剖宫产有再孕想法的手术者50人作为本次研究的对照组。对观察组产妇施以阴道分娩,设置专业的医护人员对产妇的产程随时跟进,对照组产妇使用常规剖宫产。相较两组新生儿的Apgar评分,产妇在产后的出血量以及入院的时间时长。结果观察组患者经阴道成功分娩47例,成功率达到了67.14%。两组产妇的新生儿Apgar评分相较,产妇的产后出血情况均无显著差异;而观察组产妇的产褥污染以及入院时长均低于对照组产妇,两者存在显著差异,具有统计学意义(P<0.05)。结论只有对瘢痕子宫产妇再次阴道分娩的产程进行密切观察,同时要熟练掌握子宫破裂的早期诊断重点,更要及时的对子宫破裂进行预判和干预。本次研究结果发现瘢痕子宫产妇再次阴道分娩的安全性较高,可以根据产妇的具体情况以及身体机能,给予阴道试产,具有临床推广意义。

Objective To investigate the safety of uterine cicatricial uterine vaginal delivery and the diagnosis of uterine rupture during delivery. Methods Through from birth in our hospital during the period from January 2015 to December 2016 the scar uterine pregnancy 70 women were selected as the observation group of the research object, at the same time from the same stage of cesarean section surgery pregnancy idea 50 people were selected as the control group in this study. In the observation group, the pregnant women were given vaginal delivery, and specialized medical and nursing staff were set up to follow up the maternity process at any time. The control group were used regular cesarean section. Compared with the Apgar score of two groups of newborns, the amount of postpartum hemorrhage and the time of admission were long. Results In the observation group, 47 cases were successfully delivered through the vagina, and the success rate was 67.14%. There was no significant difference in the Apgar score between the two groups, but there was no significant difference in postpartum hemorrhage between the two groups. The puerperal contamination and the length of hospitalization in the observation group were all lower than that of in the control group. There was a significant difference between the two groups（P〈0.05）.Conclusion We should pay close attention to the labor process of vaginal delivery for the pregnant women with scarred uterus, and master the key point of early diagnosis of uterine rupture. The results shows that the safety of vaginal delivery for the scarred uterus is relatively high, and it is possible to give vaginal trial delivery according to the specific condition of the pregnant woman and the physical function,which is of clinical significance.