妊娠合并瘢痕子宫经阴道分娩的安全性分析

Safety analysis of vaginal birth after cesarean section

目的:评估瘢痕子宫再次妊娠后经阴道试产的安全性及可行性。方法:回顾性分析2017年10月至2018年10月在山西医科大学第一医院分娩的单胎足月妊娠合并瘢痕子宫的孕妇75例,其中31例成功经阴道分娩者设为阴道分娩组,44例以剖宫产分娩者设为剖宫产组;另选取40例同期首次单胎妊娠经阴道分娩者作为对照组,观察三组分娩情况、新生儿情况及产后并发症情况。结果:阴道分娩组孕妇宫颈Bishop评分、产时出血量、住院时间、住院费用、新生儿体重各指标与剖宫产组比较,差异有统计学意义(P<0.05),而与对照组的差异无统计学意义(P>0.05)。结论:结合患者产前检查情况、入院情况及其意愿,在严格评估和严密监护下,瘢痕子宫再次妊娠后经阴道分娩是安全可行的。但在试产之前,必须告知其相关风险。

Objective: To evaluate the safety and feasibility of vaginal trial production after re-pregnancy in women with a single cesarean section history. Methods: Retrospective analysis of 75 pregnant women who were single caesarean section and gave birth in the First Hospital of Shanxi Medical University from October 2017 to October 2018, 31 of them were established as a vaginal delivery group, and 44 patients were set up as a cesarean section for caesarean section delivery. A further 40 cases of vaginal delivery of single pregnancy in the same period were selected as control group. Valuate the delivery conditions, the neonatal conditions and postpartum complications. Results: There was a statistically significant difference between cervical Bishop score, time-birth hemorrhage, hospitalization time, hospitalization cost, neonatal weight between cesarean section group and the vaginal delivery group (P<0.05). However, there were no significant differences between vaginal production and control group (P>0.05). Conclusion: Combined with the prenatal examination, admission and willingness of patients, it is safe and feasible to give scar uterus through vaginal delivery under strict evaluation and strict supervision. But before trial production, it must be informed of its success rate and the risk of uterine rupture.