瘢痕子宫再次妊娠阴道分娩的临床效果及安全性分析

Clinical effect and safety analysis of vaginal delivery in scarred uterus with second pregnancy

目的分析瘢痕子宫再次妊娠阴道分娩临床效果和安全性。方法选取本院产科2016年1月至2017年1月接诊的瘢痕子宫再次妊娠产妇120例,按照分娩方式的不同将其分为剖宫产组65例,自然分娩组55例,同时选取同期在本院分娩的正常子宫妊娠产妇60例,作为对照组,回顾性分析3组产妇的临床资料,对比3组产妇的产时出血量、住院时间、产褥的发生率与新生儿窒息率。结果剖宫产组的产时出血量(352.1±40.12)ml、住院时间为(3.68±1.45)d,产褥的发生率为21.81%,新生儿窒息率为5.45%;自然分娩组产时出血量(124.2±33.12)ml、住院时间为(4.12±0.35)d,产褥的发生率为4.61%,新生儿窒息率为3.07%;对照组产妇的产时出血量(122.2±31.82)ml、住院时间为(4.21±0.31)d,产褥的发生率为3.33%,新生儿窒息率为5%;可见自然分娩组产妇的产时出血量、住院时间和产褥的发病率均低于剖宫产组(P<0.05),两组新生儿窒息率对比差异无统计学意义;自然分娩组与对照组产妇的观察指标对比差异无统计学意义。结论明确阴道分娩指征、密切观察产妇的产程进展的基础上,瘢痕子宫再次妊娠产妇进行阴道分娩是可行的,且安全性也有一定保证。

Objective To analyze the clinical effect and safety of vaginal delivery in scarred uterus with second pregnancy.Methods 120 cases of pregnant women with scarred uterus from January 2016 to January 2017 were selected and divided into cesarean section group(65 cases)and natural delivery group(55 cases).At the same time,60 cases of pregnant women with normal uterus delivered in our hospital during the same period were selected as the control group.The clinical data of three groups of pregnant women were retrospectively analyzed.The amount of bleeding during delivery and the rate of bleeding during delivery were compared among the three groups.Hospitalization time,incidence of puerperium and neonatal asphyxia.Results In the cesarean section group,the amount of intrapartum hemorrhage(352.1±40.12)ml,hospitalization time were(3.68±1.45)days,the incidence of puerperal bleeding was 21.81%,the incidence of neonatal asphyxia was 5.45%;in the natural delivery group,the amount of intrapartum hemorrhage(124.2±33.12)ml,hospitalization time was(4.12±0.35)days,the incidence of puerperinatal bleeding was 4.61%,the rate of neonatal asphyxia was 3.07%;in the control group,the amount of intrapartum hemorr(122.2±31.82)ml,hospitalization time was(4.21±0.31)days,the incidence of puerperium was 3.33%,and the incidence of neonatal asphyxia was 5%.It can be seen that the amount of intrapartum hemorrhage,hospitalization time and morbidity of puerperium in natural delivery group were lower than those in cesarean section group(P<0.05).There was no significant difference in the incidence of neonatal asphyxia between the two groups.Meaning.Conclusion On the basis of defining the indications of vaginal delivery and closely observing the progress of the parturient process,it is feasible and safe for the parturient with scarred uterus to perform vaginal delivery again.