疤痕子宫再次妊娠二次剖宫产与非疤痕子宫剖宫产的对比研究

Comparative study of second cesarean section in scarred uterus re-pregnancy and non-scarred cesarean section

目的对比疤痕子宫再次妊娠二次剖宫产与非疤痕子宫剖宫产的差异。方法选取2017年3月~2018年3月收治的80例疤痕子宫再次妊娠二次剖宫产分娩的产妇为观察组,同期收治的80例非疤痕子宫妊娠分娩的产妇为对照组。比较两组子宫异常发生情况、临床指标、新生儿生理指标。结果观察组子宫异常发生率(8.75%)明显高于对照组(1.25%),差异具有统计学意义(P<0.05)。观察组术中出血量、产后出血量分别为(512.63±51.67)、(257.36±25.41)ml,均多于对照组的(447.25±44.36)、(189.39±18.83)ml,手术时间、产后恶露持续时间分别为(63.27±6.41)min、(49.27±4.86)d,均长于对照组的(45.79±4.53)min、(41.16±4.25)d,差异均具有统计学意义(P<0.05)。观察组新生儿乳酸水平(5.55±1.45)mmol/L明显高于对照组的(1.65±0.25)mmol/L,胆红素指数(19.39±1.36)低于对照组的(22.77±2.44),新生儿阿氏评分(Apgar)(9.33±0.65)分高于对照组的(8.26±1.14)分,差异均有统计学意义(P<0.05)。结论疤痕子宫再次妊娠风险较大,临床不可将剖宫产作为统一的分娩方式,尽可能的为产妇提供阴道试产的机会,以减少再次妊娠风险。

Objective To compared the difference of second cesarean section in scarred uterus repregnancy and non-scarred cesarean section.Methods A total of 80 cases of second cesarean section in scar uterus pregnancy from March 2017 to March 2018 were selected as the observation group,and concurrent 80 cases of non-scarred cesarean section as control group.Comparison was made on occurrence of uterine abnormalities,clinical indicators and neonatal physiological indicators in two groups.Results The observation group had obviously higher uterine abnormality rate(8.75%)than the control group(1.25%),and the difference was statistically significant(P<0.05).The observation group had larger amount of intraoperative hemorrhage and postoperative hemorrhage respectively as(512.63±51.67)and(257.36±25.41)ml than(447.25±44.36)and(189.39±18.83)ml in the control group,and longer operation time and duration of postpartum lochia respectively as(63.27±6.41)min and(49.27±4.86)d than(45.79±4.53)min and(41.16±4.25)d in the control group.Their difference was statistically significant(P<0.05).The observation group had obviously higher level of neonatal lactic acid as(5.55±1.45)mmol/L than(1.65±0.25)mmol/L in the control group,lower bilirubin index as(19.39±1.36)than(22.77±2.44)in the control group,and higher neonatal Apgar score as(9.33±0.65)points than(8.26±1.14)points in the control group.Their difference was statistically significant(P<0.05).Conclusion The second cesarean section of scarred uterus pregnancy shows a higher risk of pregnancy.Cesarean section can not be used as a unified mode of delivery in clinic.The opportunity of vaginal trial delivery should be provided as much as possible,so as to reduce the risk of re-pregnancy.