剖宫产后再次妊娠选择不同分娩方式对分娩结局的影响分析

Analysis of the Effect of Different Delivery Methods on Delivery Outcome after Cesarean Section

目的探讨剖宫产后再次妊娠不同分娩方式及分娩结局,为剖宫产后再次妊娠不同分娩方式的选择提供依据。方法选取该院2016年1月—2018年1月收治的80例剖宫产后再次妊娠的产妇,根据不同再次妊娠不同分娩方式分为两组,对照组(n=40)接受剖宫产,观察组(n=40)接受阴道分娩,对比产妇分娩结局和新生儿结局以及新生儿Apgar评分。结果观察组产妇产后2 h出血量和产褥感染、子宫切除率以及住院费用分别为(192.24±30.24)mL、1例(2.50%)、0例(0.00%)、(2970.15±556.12)元,明显低于对照组(376.54±45.24)mL、5例(12.50%)、2例(5.00%)、(8367.11±654.47)元,住院时间(2.79±0.78)d明显短于对照组(5.31±1.28)d,差异有统计学意义(t/χ^2=33.043、7.207、5.128、39.744、10.633,P<0.05)。观察组新生儿吸入性肺炎、肺不张、黄疸、湿肺、窒息发生率分别为2例(5.00%)、1例(2.50%)、1例(2.50%)、1例(2.50%)、4例(10.00%),对照组分别为3例(7.50%)、2例(5.00%)、2例(5.00%)、2例(5.00%)、5例(12.50%),对比差异无统计学意义(χ^2=0.533、0.866、0.866、0.866、0.313,P>0.05)。观察组Apgar评分(7.81±1.51)分,对照组Apgar评分(7.75±1.47)分,两组新生儿Apgar评分对比差异无统计学意义(t=0.180,P>0.05)。结论剖宫产后再次妊娠阴道分娩可改善产妇结局,建议进行宫产后再次妊娠阴道试产,保障母婴安全。

Objective To investigate the different modes of delivery and the outcome of delivery after cesarean section,and to provide a basis for the choice of different modes of delivery after cesarean section.Methods Eighty women who underwent cesarean section re-pregnancy were enrolled in our hospital(January 2016~January 2018).They were divided into two groups according to different delivery methods.The control group(n=40)received cesarean section.The observation group(n=40)received vaginal delivery,comparing maternal delivery outcomes with neonatal outcomes and neonatal Apgar scores.Results The postpartum 2 h hemorrhage and puerperal infection,hysterectomy rate and hospitalization cost were(192.24±30.24)mL,1 case(2.50%),0 case(0.00%)and(2970.15±556.12)yuan,respectively,which were significantly lower in the observation group of(376.54±45.24)mL,5 cases(12.50%),2 cases(5.00%),(8376.11±654.47)yuan,hospitalization time(2.79±0.78)d was significantly shorter than the control group(5.31±1.28)d,the difference was statistically significant(t/χ^2=33.043,7.207,5.128,39.744,10.633,P<0.05).The incidence of neonatal aspiration pneumonia,atelectasis,jaundice,wet lung and asphyxia in the observation group were 2 cases(5.00%),1 case(2.50%),1 case(2.50%),1 case(2.50%),and 4 cases(10.00%).The control group was 3 cases(7.50%),2 cases(5.00%),2 cases(5.00%),2 cases(5.00%),and 5 cases(12.50%),respectively.The difference was not significant and was not statistically significant(χ^2=0.533,0.866,0.866,0.866,0.313,P>0.05).The Apgar score of the observation group was(7.81±1.51)points,and that of the control group was(7.75±1.47)points.There was no significant difference in the Apgar score between the two groups(t=0.180,P>0.05).Conclusion Re-pregnancy vaginal delivery after cesarean section can improve maternal outcomes.It is recommended to perform vaginal trials after uterine delivery to ensure maternal and child safety.