前次剖宫产后阴道成功分娩的相关影响因素分析

Analysis of Related Factors of Successful Vaginal Delivery After Cesarean Section

目的分析前次剖宫产后阴道成功分娩的相关影响因素。方法回顾性分析2014年6月~2017年6月间河南省濮阳市油田总医院妇产科收治的210例首次剖宫产后阴道试产的孕妇临床资料,根据是否成功经阴道分娩分为成功分娩组(n=156)和中转剖宫产组(n=54),对比两组一般资料并经logistics回归,分析影响首次剖宫产后阴道成功分娩的相关影响因素。结果 (1)产妇体质量<30kg/m2者、距首次剖宫产时间更长者、首次剖宫产指征非复发型者、入院时宫口开大>3cm、无头盆相对不称者首次剖宫产后阴道试产成功率更高(P<0.05);(2)产妇体质量、距首次剖宫产时间、入院时宫口开大≤3cm、头盆相对不称是影响首次剖宫产后阴道分娩成功率的危险因素(P<0.05)。结论影响首次剖宫产后阴道分娩成功率的危险因素较多,临床实施阴道试产时需严格把握孕产妇适应征。

objective To analyze the influential factors of successful vaginal delivery after cesarean section. Methods A retrospective analysis was performed on the clinical data of 210 pregnant women undergoing vaginal trial after cesarean section in the Department of Obstetrics and Gynecology at the General Hospital of Puyang City, Henan Province from June 2014 to June 2017.According to the success of the vaginal delivery,patients were divided into successful delivery groups（n=156） and transit cesarean section group（n=54）.Compared two groups of general information and the logistics regression to analyze the relevant factors affecting successful vaginal delivery after the first cesarean section.Results（1） If the maternal body mass was less than 30kg/m2, the time was longer than the first cesarean section, the first cesarean section was non-recurrent,the cervix was opened up to 3cm when admitted in the hospital,the head match the pelvis,the success rate of postpartum vaginal trial production is higher（P 〈 0.05）;（2） Factors such as maternal body mass, time from the first cesarean section, entrance cervix ≤ 3cm are known to affect the success rate of vaginal delivery after cesarean section.（P 〈 0.05）. Conclusion There are many risk factors affecting the success rate of vaginal delivery after the first cesarean section. It is necessary to strictly grasp the maternal indications in clinical vaginal trial production.