临床瘢痕子宫阴道试产的母儿结局分析

Analysis of Maternal and Infant Outcomes of Clinical Scar Uterus Vaginal Trial Delivery

目的分析产妇足月妊娠后瘢痕子宫阴道试产的母儿结局。方法选取2017年1月—2019年5月于医院进行阴道试产的150例裂痕子宫产妇参与本次研究,按照分娩结果将所有产妇分为两组,阴道试产成功的产妇为成功组,阴道试产失败的产妇为失败组。对两组从产妇的母儿结局作出分析与比较。结果阴道试产成功例数为107例,阴道试产成功率为71.33%,阴道试产失败转急诊剖宫产例数为43例,阴道试产失败率为28.67%;成功组自然临产率高于失败组,新生儿窒息、子宫先兆破裂、胎心异常、妊娠合并症、产后感染及新生儿并发症等发生率低于失败组;成功组产程时间、自主哺乳时间以及住院时间均短于失败组,出血量少于失败组;P<0.05。结论在符合阴道试产条件及严密的监护流程下,阴道试产是瘢痕子宫产妇较为合理且安全的分娩方式,可有效改善母儿结局。

Objective To analyze the maternal and child outcomes of uterine and vaginal trial delivery after full-term pregnancy.Methods A total of 150 women with a ruptured uterus who had a vaginal trial in our hospital from January 2017 to May 2019 were selected to participate in this study.According to the results of childbirth,all the women were divided into two groups,those who had a successful vaginal trial were classified as the success group,and those who had a failed vaginal trial as the failure group.The maternal and child outcomes of the two groups were analyzed and compared.Results The success rate of vaginal trial delivery was 71.33%,and the failure rate of vaginal trial delivery was 28.67%.The rate of natural labor in the successful group was higher than that in the failure group,and the incidence of neonatal asphyxia,uterine rupture,fetal heart abnormality,pregnancy complications,postpartum infection and neonatal complications was lower than that in the failure group.The duration of labor,self-feeding and hospitalization in the successful group was shorter than that in the failed group,and the amount of blood loss was less than that in the failed group.(P<0.05).Conclusion In accordance with the conditions of vaginal trial labor and the strict monitoring process,vaginal trial labor is a reasonable and safe delivery method for pregnant women with scar uterus,which can effectively improve maternal and infant outcomes.