自由体位分娩对疤痕子宫阴道分娩患者阴道试产成功率及安全性的影响

Effects of free position delivery on the success rate and safety of vaginal trial delivery in patients with scar uterus and vagina

目的探讨自由体位分娩对疤痕子宫阴道分娩患者阴道试产成功率及安全性的影响。方法选取2018年1~12月高州市人民医院妇产科收治的疤痕子宫阴道分娩者80例,采用随机数表法将其分为研究组和对照组,各40例。研究组采用自由体位分娩,对照组采用常规体位分娩。比较阴道试产成功率及安全性。结果研究组产妇阴道试产成功率高于对照组,中转剖宫产率明显低于对照组,第一、二、三产程时间及住院时间均明显短于对照组,产中和产后出血量均明显少于对照组,会阴侧切率、会阴裂伤率和宫颈裂伤率均明显低于对照组,新生儿Apgar评分明显高于对照组,产妇满意度明显高于对照组,差异有统计学意义(均P<0.05);阴道助产率低于对照组,但差异无统计学意义(P>0.05)。结论疤痕子宫阴道分娩患者选择自由体位分娩可提高阴道试产成功率,缩短产程,减少恶性事件,安全可行。

Objective To explore the influence of free position delivery on the success rate and safety of vaginal trial-birth in patients with scar uterus and vaginal delivery.Methods A total of 80 cases of scar uterus and vaginal delivery admitted to the department of obstetrics and gynecology of Gaozhou People's Hospital from January to December 2018 were selected and randomly divided into study group and control group with 40 cases each.The study group delivered in free position,and the control group delivered in conventional position.Compare the success rate and safety of vaginal trial delivery.Results Team success rate of maternal vaginal trial production was higher than the control group,transit cesarean delivery rate was significantly lower than the control group,the first,second and third labor time and hospital stay were significantly shorter than the control group,during and after the bleeding were significantly less than the control group,episiotomy rate,the rates of perineal laceration and cervical laceration were significantly lower than the control group,neonatal Apgar score significantly higher than the control group,and maternal satisfaction is significantly higher than the control group,the differences were statistically significant(P<0.05).Vaginal birth rate was lower than the control group,but the difference was not statistically significant(P>0.05).Conclusions Choosing free position for vaginal delivery with scar uterus can improve the success rate of vaginal trial delivery,shorten labor process,reduce malignant events,and be safe and feasible.