瘢痕子宫足月妊娠合并子宫肌瘤孕妇阴道分娩的临床研究

Clinical Study of Vaginal Delivery in Pregnant Women with Uterine Fibroids with Uterine Fibroids

目的探讨瘢痕子宫足月妊娠合并子宫肌瘤孕妇阴道分娩的临床效果及安全性。方法方便选取该院(2016年10月—2018年8月)收治的78例瘢痕子宫再次足月妊娠分娩合并子宫肌瘤孕妇作为研究组,将同期78例非瘢痕子宫再次足月妊娠分娩合并子宫肌瘤孕妇作为对照组。对比两组孕妇的分娩结局及成功率、分娩指标、分娩后并发症率。结果研究组孕妇阴道试产率(17.95%)、自然分娩率(16.67%)均显著低于对照组(30.77%、60.26%),组间均差异有统计学意义(χ~2=4.459 8、17.138 0,P<0.05);研究组孕妇剖宫产率(61.54%)显著高于对照组(8.05%),组间均差异有统计学意义(χ~2=13.054 7,P<0.05)。两组孕妇产后出血量相比差异无统计学意义(t=0.432 9、0.437 4, P﹥0.05);研究组孕妇住院时间长于对照组,且组间差异有统计学意义(t=3.768 5、3.769 7, P<0.05)。研究组新生儿Apgar评分低于对照组,且组间差异有统计学意义(t=2.695 7、4.925 4,P<0.05)。结论瘢痕子宫足月妊娠合并子宫肌瘤孕妇的剖宫产率高于非瘢痕子宫足月妊娠合并子宫肌瘤孕妇,但产妇产后出血量并无显著差异。瘢痕子宫足月妊娠合并子宫肌瘤不能直接作为剖宫产的绝对指征,也可以根据孕妇及胎儿情况完成自然分娩,其分娩结局具有一定临床价值。

Objective To investigate the clinical efficacy and safety of vaginal delivery in pregnant women with uterine fibroids with uterine fibroids.Methods 78 cases of scar uterus admitted to our hospital(October 2016 to August 2018)were convenient selected and treated as full-term pregnancy and delivery of uterine fibroids as a research group.78 cases of non-scarred uterus and full-term pregnancy were combined with uterine muscle pregnant women with tumors served as a control group.The outcomes and success rates of the two groups of pregnant women,the delivery index,and the postpartum complication rate were compared.Results The vaginal test yield(17.95%)and the natural delivery rate(16.67%)of the study group were significantly lower than those of the control group 30.77%and 60.26%.The differences between the groups were statistically significant(χ^2=4.459 8,17.138 0,P<0.05);the cesarean section rate of the study group(61.54%)was significantly higher than that of the control group(8.05%),and the difference between the groups was statistically signif icant(χ^2=13.054 7,P<0.05).There was no significant difference in postpartum hemorrhage between the two groups(t=0.432 9,0.437 4,P>0.05).The length of hospital stay in the study group was longer than that in the control group,and the difference between the groups was statistically significant(t=3.768 5,3.769 7,P<0.05).The Apgar score of the newborns in the study group was lower than that of the control group,and the difference between the groups was statistically significant(t=2.695 7,4.925 4,P<0.05).Conclusion The cesarean section rate of pregnant women with uterine fibroids with uterine fibroids is higher than that of non-scarred uterine full-term pregnancy with uterine fibroids,but there is no significant difference in maternal postpartum hemorrhage.Scar uterine full-term pregnancy with uterine fibroids can not be directly used as an absolute indication for cesarean section,but also can be completed according to the situation of pregnant women and fetuses,the delivery outcome has a certain clinical value.