瘢痕子宫阴道分娩的临床观察

Clinical observation of uterine scar vaginal delivery

目的:分析瘢痕子宫再次妊娠行阴道分娩的临床可行性及安全性。方法:收治瘢痕子宫产妇140例,分为阴道分娩组(A组)和剖宫产组(B组)。选择同期非瘢痕子宫阴道分娩成功产妇100例为对照组(C组)。结果:(1)A组产后2 h出血量、住院时间、住院费用、并发症发生率明显低于B组(P<0.05)。新生儿Apgar评分A组和B组比较,差异无统计学意义(P>0.05)。(2)A组和C组产后2 h出血量、住院时间、住院费用、并发症发生率比较,差异无统计学意义(P>0.05),但A组的阴道助产率明显高于C组(P<0.05),A组和C组新生儿Apgar评分差异无统计学意义(P>0.05)。结论:充分评估后,瘢痕子宫阴道分娩是可行的,母婴预后良好,但在试产过程中,需严密监护和做好即刻剖宫产准备。

Objective:To explore the clinical feasibility and safety of vaginal delivery of uterine scar.Methods:140cases of parturients with uterine scar were selected and they were divided into the vaginal delivery group(A group)and the cesarean section(B group),and100cases of parturients without uterine scar and with successful vaginal delivery were selected as the control group(C group).Results:①In the A group,the amount of bleeding at postpartum2hours,hospitalization time,hospitalization cost and complication rate were significantly lower than those in the B group(P<0.05).There was no significant difference in newborn Apgar,s score between the A group and the B group(P>0.05).②There was no significant difference in the amount of bleeding at postpartum2hours,hospitalization time,hospitalization cost and complication rate between the A group and the C group(P>0.05),however,the rate of vaginal delivery in the A group was significantly higher than that in the C group(P<0.05),and there was no significant difference in newborn Apgar,s score between the A group and the C group(P>0.05).Conclusion:After full evaluation,vaginal delivery of uterine scar was feasible,maternal and fetal prognosis was good,however,in the trial production process,we need to be closely monitored and ready for immediate cesarean section.