剖宫产术后瘢痕子宫二次妊娠阴道分娩的可能性分析

Analysis of the Possibility of Vaginal Delivery in the Second Pregnancy of Scar Uterus after Cesarean Section

目的分析剖宫产术后瘢痕子宫二次妊娠阴道分娩的可能性。方法选择2016年1月～2017年12月于本院产科收治的剖宫产术后瘢痕子宫二次妊娠患者187例,以选择阴道分娩者为观察组,以不符合阴道分娩入选标准试产失败者及自愿放弃者作为二次剖宫产分娩对照组。记录两组孕妇分娩情况、阴道出血量、感染率和新生儿Apgar评分。结果未进行阴道分娩试产直接进行二次剖宫产者119例,阴道分娩试产成功62例,失败6例。观察组阴道出血量明显低于对照组,差异有统计学意义(P <0.05)。观察组新生儿Apgar评分、感染率与对照组患者相比均无显著差异(均P> 0.05)。结论符合试产条件的剖宫产术后瘢痕子宫二次妊娠阴道试产具有较高的成功率、安全性较好,在严格规范指征的前提下,剖宫产术后瘢痕子宫二次妊娠阴道试产具有较好的可行性。

Objective To analyze the possibility of vaginal delivery in the second pregnancy of scar uterus after cesarean section. Methods A total of 187 patients with secondary uterine scar pregnancy after cesarean section admitted to our hospital from January 2016 to December 2017 for obstetrics were selected. The vaginal delivery was selected as the observation group, and the trial failed in accordance with the criteria for vaginal delivery. And voluntary abandoners as a secondary cesarean delivery control group. Childbirth, vaginal bleeding, infection rate, and neonatal Apgar scores were recorded for both groups. Results There were 119 cases of secondary cesarean section without vaginal delivery, 62 cases of vaginal delivery and 6 cases of failure. The amount of vaginal bleeding in the observation group was significantly lower than that in the control group (P < 0.05). There was no significant difference in Apgar score and infection rate between the observation group and the control group (P > 0.05). Conclusions The vaginal trial of scar uterus secondary pregnancy after cesarean section in accordance with the trial production condition has a high success rate and good safety. Under the premise of strict standard indication, the second pregnancy of scar uterus after cesarean section Vaginal trial production has good feasibility.