剖宫产后再次妊娠经阴道分娩的临床观察

Clinical Observation of Vaginal Delivery after Cesarean Section

目的探讨剖宫产术后再次妊娠经阴道分娩(VBAC)的可行性和安全性,为推进VBAC提供依据。方法回顾性分析2010年1月-2018年10月我院住院的VBAC患者(40例)和同期非瘢痕子宫妊娠后阴道分娩患者(40例)临床资料,比较两组产妇产程时间、产后出血量、住院时间、住院费用、阴道助产率等妊娠结局及新生儿体质量和Apgar评分,探讨VBAC的可行性。结果两组产妇的产程时间、产后出血量、住院时间、住院费用、新生儿体质量和Apgar评分差异均无统计学意义(P均>0.05),观察组阴道助产率(25%)与对照组(15%)差异无统计学意义(χ~2=0.16,P>0.05)。结论剖宫产术后再次妊娠通过严格筛选、严密观察、规范处理,经阴道分娩是可行的。

Objective To investigate the feasibility and safety of vaginal delivery(VBAC)after cesarean section and to provide clinical data for the promotion of VBAC.Methods Retrospective analysis of 40 cases of VBAC patients hospitalized in our hospital from January 2010 to October 2018,compared with 40 cases of vaginal delivery after non-scar uterine pregnancy in the same period.The pregnancy outcomes such as birth time,postpartum hemorrhage,hospitalization time,hospitalization cost,vaginal delivery rate and neonatal weight and Apgar score were compared between the two groups to explore the feasibility of VBAC.Results There was no significant difference between the two groups of women with vaginal delivery in the time of labor,postpartum hemorrhage,hospitalization time,hospitalization expenses,vaginal delivery rate,newborn weight and Apgar score(P>0.05),there was no significant difference showed in midwifery rate bettween the observation group(25%)or control group(15%)(χ~2=0.16,P>0.05).Conclusion It is feasible to perform vaginal delivery after Caesarean section by strict screening,close observation and standard treatment.