剖宫产术后再次妊娠经阴道分娩的可行性及安全性研究

Study on the Feasibility and Safety of Vaginal Delivery after Re-pregnancy after Cesarean Section

目的探讨剖宫产术后再次妊娠经阴道分娩的可行性及安全性。方法将2014年5月至2017年5月我院接收的240例经剖宫产术后再次妊娠的孕妇随机分成观察和对照两组(n=120例),采取不同的分娩方式。结果 (1)两组孕妇分娩指标的比较:观察组产时出血量(312.23±20.44)m L、住院时间(4.46±1.28)d及新生儿评分(9.25±0.14)分与对照组剖宫产时出血量(312.15±21.03)m L、住院时间(4.52±1.14)d及新生儿评分(9.18±0.22)分差异不大,不具有统计学意义(P>0.05);(2)两组孕妇生产后焦虑抑郁情况评分的比较:观察组经过生产后的焦虑评分(21.42±5.86)分和抑郁评分(23.39±3.44)分均优于对照组经过生产后的焦虑评分(35.77±6.32)分和抑郁评分(40.76±5.21)分(P<0.05);(3)观察组的并发症率和子宫破裂率分别为5.0%、3.3%,均要明显优于对照组的13.3%、8.3%,差异有统计学意义(P<0.05)。结论对经剖宫产术后再次妊娠的产妇使用经阴道分娩的方式指导产妇进行分娩,拥有着良好的分娩效果,对于患者的生命安全也有着良好的保障,值得推广。

Objective To explore the feasibility and safety of vaginal delivery of second pregnancy after cesarean section. Methods 240 cases of pregnant women who had undergone cesarean section pregnancy from May 2014 to May 2017 were randomly divided into observation and control groups （n=120）. Different delivery methods were adopted. Results （1） Comparison of maternal delivery parameters between the two groups： In the observation group, blood loss （312.23 ± 20.44） milliliters, hospital stay （4.46 ±1.28） days, neonatal score （9.25 ± 0.14）, and cesarean section of the control group were observed. The blood loss （312.15 ± 21.03） mL, hospital stay （4.52 ± 1.14） days, and neonatal score （9.18± 0.22） were not significantly different （P〉0.05）; Comparison of post-anxiety and depression scores： The post-production anxiety score （21.42 ±5.86） and the depression score （23.39 ± 3.44） in the observation group were better than those in the control group after production （35.77± 6.32）. Scores and scores of depression were （40.76 ±5.21） points （P〈0.05）; （3） The complication rate and uterine rupture rate in the observation group were 5.0% and 3.3%, respectively, which were significantly better than those in the control group 13.3% and 8.3%. The difference was statistically significant （P〈0.05）. Conclusion The use of vaginal delivery to deliver maternal childbirth after cesarean section has a good delivery effect. It also has good protection for the patient＇s life safety and worthy of promotion.