剖宫产后瘢痕子宫再次妊娠分娩方式探讨

Discussion on Delivery Mode of Scar Uterus Pregnancy Again after Cesarean Section

目的探讨剖宫产后瘢痕子宫再次妊娠分娩方式。方法选取中国人民解放军第九五医院2016年6月—2017年6月收治的瘢痕子宫再次妊娠产妇110例,将再次采取剖宫产方式的64例产妇设为观察组a,将经阴道试产成功的46例产妇设为观察组b。选取本院同期首次采取剖宫产产妇64例设为对照组a,首次采取阴道分娩产妇46例设为对照组b。比较两组剖宫产产妇产后出血率、重度粘连率、切口乙级愈合率;比较两组阴道分娩产妇产后出血量及先兆子宫破裂、新生儿窒息发生率。结果观察组a产妇产后出血率、重度粘连率、切口乙级愈合率高于对照组a(P<0.05)。观察组b与对照组b产妇产后出血量及先兆子宫破裂、新生儿窒息发生率比较,差异无统计学意义(P>0.05)。结论瘢痕子宫选择妊娠分娩方式时可在与相关指征相符合的情况下,选择安全性和可行性均较高的阴道试产方式,但需避免子宫破裂发生。

Objective To investigate the delivery mode of scar uterus pregnancy again after cesarean section.Methods A total of110cases of scar uterus pregnancy again maternal were selected from June2016to June2017in the95hospital of PLA,64cases of maternal underwent cesarean section as observation group a,40cases of maternal vaginal delivery as observation group b.64cases of maternal with cesarean section for the first time were selected as control group a,46cases of maternal vaginal delivery for the first time were selected as control group b.The rate of postpartum hemorrhage,severe adhesion,incision b healing were compared between the two groups with cesarean section,and the postpartum haemorrhage amount and the incidence of aura of uterine rupture,neonatal asphyxia were compared between the two groups with vaginal delivery.Results The observation group a of rate of postpartum hemorrhage,severe adhesion,incision b healing were higher than control group a(P<0.05).No significant differences of postpartum haemorrhage amount or the incidence of aura of uterine rupture,neonatal asphyxia was found between the observation group b and control group b(P>0.05).Conclusion We can be in accord with the condition of indication selection when selecting the mode of delivery for the scarred uterus,so should select a higher safety and feasibility vaginal delivery,but should pay more attention to avoid the occurrence of uterus rupture.