瘢痕子宫阴道分娩45例临床分析

Clinical analysis of 45 cases of vaginal delivery of scar

目的探讨瘢痕子宫阴道分娩的可能性及安全性。方法选取2012年1月~2016年12月本院收治的45例瘢痕子宫再次妊娠选择阴道分娩的孕妇作为研究对象,在严格掌握阴道分娩指征的情况下,分析阴道试产成功率、平均产程、阴道分娩出血量及新生儿评分、体质量等。结果 45例瘢痕子宫产妇,其中37例阴道试产成功(82.22%),8例改为剖宫产手术,未出现子宫破裂。阴道助产3例,平均产程(6.32±0.35)h,产时出血量(223.45±38.46)m L,产后出血量(435.92±45.78)m L,新生儿Apgar评分<8分1例,新生儿体质量(3267.74±26.76)g。结论通过严格把握瘢痕子宫阴道分娩的指征、严密观察产程、做好并发症的准备、取得孕妇及家属的配合,瘢痕子宫实施阴道分娩,结局良好,并发症低,可进行推广。

Objective To investigate the possibility and safety of vaginal delivery in scared uterus.Methods A total of 45 cases of vaginal delivery were selected from January 2012 to December 2016 in this hospital.The pregnant women who chose vaginal delivery were selected as the study subjects.The vaginal trial production success rate and average labor duration,vaginal bleeding and neonatal scores,body weight were analyzed under the strict control of vaginal delivery.Results Among the 45 cases of uterine scars,37 cases(82.22%)were successful vaginal tests.8 cases were changed to cesarean section and no uterine rupture occurred.There were 3 cases of vaginal midwifery,average labor duration was(6.32±0.35)h,blood loss at delivery was(223.45±38.46)mL,postpartum hemorrhage was(435.92±45.78)mL,1 case of neonatal Apgar score<8 points,neonatal body mass was(3267.74±26.76)g.Conclusion By strictly grasping the indications of vaginal delivery of scars and uterus,closely observing the labor process,preparing for complications and obtaining the cooperation of pregnant women and their families,vaginal delivery of scars and uterus results in good outcomes and low complications.