不同分娩方式对瘢痕子宫再妊娠结局的影响

The Effect of Different Delivery Modes on the Outcome of Repregnancy of Scarred Uterus

目的探讨不同分娩方式对瘢痕子宫再妊娠结局的影响。方法选取2014年1月-2018年12月在我院进行住院分娩的100例剖宫产术后瘢痕子宫再妊娠孕妇作为研究对象,按照分娩方式不同将100例孕妇分为剖宫产组(60例)和阴道试产组(40例);对两组产后24 h出血量、新生儿Apgar评分、住院时间及产妇不良事件发生情况进行对比分析。结果剖宫产组所有孕妇均手术成功;阴道试产组40例孕妇试产成功32例,8例中转剖腹产;剖宫产组产后24 h出血量显著多于阴道试产组(P<0.05),住院时间显著长于阴道试产组(P<0.05);两组新生儿Apgar评分比较差异不显著(P>0.05);剖宫产组产妇不良事件发生率显著高于阴道试产组(P<0.05)。结论无剖宫产指征的瘢痕子宫再妊娠孕妇引导试产效果良好,因此对于有阴道分娩条件且无剖宫产指征的瘢痕子宫再妊娠孕妇分娩时应尝试进行阴道分娩。

Objective To explore the effect of different delivery methods on the outcome of re-pregnancy of scarred uterus.Methods 100 pregnant women with scar uterus pregnancy after cesarean section who delivered in our hospital from January 2014 to December 2018 were selected as the research objects.According to the different delivery modes,100 pregnant women were divided into cesarean section group(60 cases)and vaginal trial group(40 cases).The amount of postpartum hemorrhage,neonatal Apgar score and hospitalization were compared between the two groups.Time and maternal adverse events were compared and analyzed.Results All the pregnant women in the cesarean section group were operated successfully;In the vaginal trial group,32 cases were successfully delivered and 8 cases were transferred to cesarean section;In the cesarean section group,the amount of bleeding at 24 hours after delivery was significantly higher than that in the vaginal trial group(P<0.05),and the length of hospital stay was significantly longer than that in the vaginal trial group(P<0.05);There was no significant difference in Apgar score between the two groups(P>0.05).The incidence of adverse events in cesarean section group was significantly higher than that in vaginal trial group(P<0.05).Conclusion Pregnant women with scarred uterus without cesarean section indication have good effect in guiding trial delivery.Therefore,vaginal delivery should be attempted for pregnant women with scarred uterus with vaginal delivery conditions and without cesarean section indication.