比较剖宫产术与阴道分娩对1064例疤痕子宫产妇再妊娠结局的影响

Comparison the effect of caesarean section and vaginal delivery on the outcome in 1064 repregnancy women with scar uterus

目的对比剖宫产术与阴道分娩对疤痕子宫产妇妊娠结局的影响。方法选取2012年5月~2018年10月我院疤痕子宫再次妊娠产妇1064例,经剖宫产分娩产妇846例纳入剖宫产术组(试产失败转剖宫产术33例),218例经阴道成功分娩的产妇纳入阴道分娩组,比较两组妊娠结局,新生儿Apgar评分、围产儿死亡发生率、产后出血及产后感染发生率。结果阴道试产成功率为86.85%,两组新生儿Apgar评分情况(1min及5min)、两组围产儿死亡发生率均无显著差异(P>0.05);产后出血及产后感染发生率亦无显著差异(P>0.05);两组均未发生子宫破裂,其中阴道分娩组出现1例先兆子宫破裂,但在密切监护下及时顺利行剖宫产术。结论在有效的监护下疤痕子宫产妇再次行阴道分娩并非绝对的禁忌,剖宫产术可作为疤痕子宫产妇再次阴道分娩失败的有效补充措施。

Objective:To analyze the effect of scar uterus on the choice of cesarean section and vaginal delivery.Methods:1064 cases of pregnant women with uterine scar were chosen from May 2012 to October 2018.846 cases of maternal cesarean section were included in cesarean section(33 cases of cesarean section failed to delivery),218 cases of successful vaginal delivery of maternal into the vaginal delivery group,compared outcome of the two groups.Results:The success rate of vaginal delivery group was 86.85%.There were no significant difference in the incidence of neonatal 1 and 5 min Apgar scores and perinatal mortality rate between the two groups(P>0.05).There were no significant difference between postpartum hemorrhage and postpartum infection(P>0.05).The incidence of uterine rupture was the same as that of vaginal delivery group.Conclusion:Under the effective supervision,vaginal delivery with scar uterus is also feasible,cesarean section can be used as a supplementary treatment with vaginal delivery.