瘢痕子宫再次妊娠阴道分娩的可行性及安全性评价

Feasibility and Safety Evaluation of Vaginal Delivery after Re-pregnancy in Scared Uterus

目的评价瘢痕子宫再次妊娠阴道分娩的可行性及安全性。方法回顾分析2016年1月~2017年12月在南华大学附属常德医院产科分娩的180例瘢痕子宫再次妊娠产妇临床资料为观察组,并选取同期在我院分娩的180例非瘢痕妊娠产妇为对照组,两组产妇均进行阴道分娩试产,对比两组产妇分娩方式、新生儿评分以及产后并发症等情况。结果观察组阴道分娩率于对照组相比,差异无统计学意义(P>0.05);观察组阴道分娩产程时间、出血量、新生儿Apgar评分、住院时间与对照组对比,差异无统计学意义(P>0.05);观察组感染、尿潴留、宫裂出血发生率等并发症发生率与对照组对比,差异无统计学意义(P>0.05)。结论瘢痕子宫再次妊娠孕妇只要进行严密的产前检查,采用正确的助产手段,行阴道分娩完全可行,且不会增加不良反应,避免了再次剖宫产对产妇子宫造成的损伤。

Objective To evaluate the feasibility and safety of vaginal delivery of scared uterus in re-pregnancy.Methods From January 2016 to December 2017,180 pregnant women with scarred uterus who were delivered in obstetrics department of Changde Hospital affiliated to Nanhua University were retrospectively analyzed as observation group,and 180 cases of non-scar pregnancy in the same period were selected as control group,the two groups of women all carried out vaginal delivery trial production,compared the two groups of parturients delivery,neonatal scores and postpartum complications.Results There was no significant difference in vaginal delivery rate between the observation group and the control group(P>0.05).There was no significant difference in vaginal delivery time,blood loss,neonatal Apgar score,and hospital stay between the observation group and the control group(P>0.05).The incidence of complications such as infection,urinary retention,and uterine fissure in the observation group was not significantly different from that in the control group(P>0.05).Conclusion It is feasible to perform vaginal delivery with strict antenatal examination and correct midwifery for pregnant women with second trimester of scar uterus,and no adverse reactions will be increased,thus avoiding the damage to the uterus caused by cesarean section.