探讨疤痕子宫二次妊娠阴道分娩的可行性及注意事项

To explore the feasibility and precautions of vaginal delivery in two pregnant women with scar uterus

目的对疤痕子宫二次妊娠阴道分娩的可行性以及注意事项进行探讨。方法选取我院自2013年5月至2015年2月接收的98名疤痕子宫再次妊娠产妇，将以上产妇随机分为观察组和对照组，每组49例，观察组进行阴道分娩，对照组实施剖宫产。对2组产妇的妊娠结局进行对比。结果观察组49名产妇的阴道分娩成功率为66.8%，共有33名产妇分娩成功；其余转为剖宫产；对照组患者以及观察组转来的产妇实施剖宫产手术全部成功。2组产妇的分娩时间和母子存活率无明显差异，生产中的出血量和住院时间存在明显差异（P<0.01)，观察组明显优于对照组。观察组产后出现并发症的概率为5.1%，有2名患者出现并发症；对照组患者出现并发症概率为18.2%，共有9名患者出现并发症。两组产妇出现并发症的情况差异较为明显，对照组显著高于观察组。结论疤痕子宫二次妊娠实施阴道分娩的可行性较高，在具体的实施中可结合产妇的情况选择合理的分娩方式，降低产妇分娩并发症发生和分娩中造成的损伤。

Objective:To investigate the feasibility of two uterine scar pregnancy vaginal delivery and the matters needing attention.Methods:In our hospital from May2013to February201598uterine scar pregnancy received again,the women were randomly divided into observation group and control group,each group of49cases,the observation group of vaginal delivery,cesarean section in the implementation of the control group.The pregnancy outcome of two groups were compared.Result:The observation group of49women with vaginal delivery success rate of66.8%,a total of33parturient success;the rest into cesarean section;patients in the control group and the observation group to the implementation of maternal cesarean section were all successful.The two groups of maternal childbirth time and child survival rate had no significant difference,there exist obvious differences in bleeding the amount of production and hospitalization time(P<0.01),the observation group was significantly better than the control group.The observation group postpartum probability of complications was5.1%,2patients had complications;patients in the control group,the probability of occurrence of complications was18.2%,there were9patients appeared complications.The differences between the two groups of maternal complications obviously,the control group was significantly higher than the observation group.Conclusion:The feasibility of vaginal delivery in two cases of uterine scar pregnancy is higher,in the specific implementation of the situation can be combined with the choice of a reasonable mode of delivery,reduce maternal complications of childbirth and birth injury