剖宫产术后瘢痕子宫再次妊娠分娩方式对母婴结局及出血量的影响

Effect of the delivery mode of scarred uterus after cesarean section on the outcome of mother and child and the amount of bleeding

目的剖宫产术后瘢痕子宫再次妊娠分娩方式对母婴结局及出血量的影响。方法选取2016年2月至2018年10月山东省新泰市人民医院诊治的124例剖宫产术后瘢痕子宫足月妊娠孕妇作为研究对象。按照分娩方式的不同将其分为阴道分娩组和再次剖宫产组,每组各62例。对所有孕妇的临床及随访资料进行回顾性分析,比较两组产妇手术、住院及母婴不良结局发生情况等。结果阴道分娩组产妇产时出血量、手术时间、住院时间、平均住院费用均少于再次剖宫产组,差异具有统计学意义(P<0.05);阴道分娩组产妇盆腔粘连、产后出血、产褥感染、恶露过长等不良结局发生率均低于再次剖宫产组,差异具有统计学意义(P<0.05);两组产妇观察组5min内Apgar评分比较差异无统计学意义(P>0.05),阴道分娩组产妇新生儿窒息、胎儿窘迫、湿肺等新生儿不良结局发生率均低于再次剖宫产组,差异具有统计学意义(P<0.05)。结论对于严格掌握适应证及符合阴道试产条件的剖宫产术后瘢痕子宫再次妊娠产妇可行阴道试产,有利于缩短住院时间,节约医疗经费,改善母婴不良结局,降低产后出血等相关并发症的发生。

Objective To observe the effect of re-pregnancy delivery mode on the outcome of mother and infant and the amount of bleeding after cesarean section.Methods A total of 142 pregnant women with uterine uterine contractions after cesarean section were enrolled in the Xintai City People′s Hospital of Shandong Province from February 2016 to October 2018.According to the different delivery methods,62 patients were divided into vaginal delivery group.62 patients were randomly selected for cesarean section in the second cesarean section.The clinical and follow-up data of all pregnant women were retrospectively analyzed.Maternal surgery,hospitalization,and the occurrence of maternal and child adverse outcomes.Results The vaginal delivery group had less maternal bleeding,operation time,hospital stay,and average hospitalization expenses(short)in the cesarean section,the difference was statistically significant(P<0.05);vaginal delivery group maternal pelvic adhesions,The incidence of adverse outcomes such as postpartum hemorrhage,puerperal infection,and excessive lochia was lower than that in the cesarean section.The difference was statistically significant(P<0.05).There was no significant difference in the Apgar score between the two groups in the maternal observation group within 5 minutes.(P>0.05),the incidence of neonatal neonatal asphyxia,fetal distress,wet lung and other neonatal adverse outcomes in the vaginal delivery group were lower than the re-cesarean section,the difference was statistically significant(P<0.05).Conclusions It is feasible to shorten the length of hospital stay,save medical expenses,improve the adverse outcomes of maternal and child,and reduce postpartum hemorrhage and other related complications for scalp uterus after cesarean section with strict indications and vaginal trial conditions.The occurrence of the disease.