高龄瘢痕子宫足月妊娠再次分娩方式对产妇及新生儿结局的影响分析

Impact analysis of re-delivery modes of scar uterus in full-term pregnancy on maternal and neonatal outcome in elderly puerperae

目的探讨高龄瘢痕子宫足月妊娠再次分娩方式对产妇及新生儿结局的影响。方法选取2015年7月~2017年3月在我院生产的高龄瘢痕子宫足月且再次分娩的产妇122例作为研究对象,根据产妇情况,分为实验组(n=36)和对照组(n=86),实验组进行阴道自然分娩,对照组进行剖宫产。观察分娩后24 h内的出血量、产褥感染率、产后发热情况、产程时间、住院时间、住院费用,以及新生儿体重和新生儿Apgar评分。结果实验组在产后24 h内的出血量少于对照组,产后发热情况低于对照组,产程时间以及住院时间均短于对照组,住院费用低于对照组,差异均有统计学意义(P<0.05);两组的产褥率和新生儿出生后的体重和Apgar评分比较,差异无统计学意义(P>0.05)。结论在高龄瘢痕子宫足月妊娠的产妇产前各项指标均满足阴道自然分娩,且医疗条件具备时,应优先选择阴道自然分娩方式。

Objective To investigate the influence of re-delivery modes of scar uterus in full-term pregnancy on maternal and neonatal outcome in elderly puerperae. Methods From July 2015 to March 2017, 122 elderly puerperae with scar uterus in full-term pregnancy who underwent a secondary delivery were randomly enrolled as study subjects. According to the maternal status, they were divided into control group（n=86） and experimental group（n=36）. In the experimental group, maternal vaginal delivery was recommended, while in the control group, maternal cesarean section was performed.The amount of blooding 24 hour after delivery, puerperal infection rate, postpartum fever, labor time, hospital stay, hospitalization costs, and neonatal weight and neonatal Apgar score were observed. Results The amount of blooding within24 hours after delivery in the experimental group was less than that in the controi group, postpartum fever was lower than that in the controi group, labor duration, hospital stay was shorter than that in the controi group, and hospitalization costs was lower than that in the controi group, the differences were statistically significant（P〈0.05）. The puerperal infection rate, neonatal weight, and Apgar score were not displayed significant differences between the two groups（P〉0.05）. Conclusion When the antenatal indexes of scar uterine in full-term term pregnancy in elderly puerperae qualifying the conditions of vaginal delivery, the vaginal delivery mode should be preferred with available medical conditions.