剖宫产术后再次妊娠孕妇分娩方式意愿及相关因素分析

Analysis on Delivery Mode Selection of Re-pregnant Women after Receiving Cesarean Section and Related Factors

目的了解剖宫产术后再次妊娠孕妇对分娩方式选择的意愿及相关影响因素,为指导孕妇选择适宜的分娩方式提供参考。方法采用方便抽样法,选取2018年8—11月于复旦大学附属妇产科医院产科门诊建卡的110例剖宫产术后再次妊娠的孕妇为研究对象,采用自行编制的剖宫产术后再次妊娠孕妇分娩方式选择意愿调查问卷对其进行调查。结果 110例剖宫产术后再次妊娠的孕妇中,选择阴道分娩54例(49.09%),选择剖宫产46例(41.82%),尚不确定10例(9.09%)。χ^2检验结果显示,不同年龄、户口类型、文化程度、职业、家庭平均月收入、上1胎剖宫产原因、孕前有无慢性疾病、朋友第2胎的分娩方式及对分娩方式认知的孕妇对分娩方式选择的意愿存在差异(P<0.05)。结论剖宫产术后再次妊娠孕妇选择再次剖宫产的意愿较高,医护人员应该强化该类人群孕期健康教育,积极调动其社会支持系统,指导其选择适宜的分娩方式,进而降低无医学指征剖宫产率。

Objective To understand re-pregnant women′ willingness to select delivery modes after receiving cesarean section and related factors, so as to provide references for pregnant women to select an appropriate mode of delivery. Methods A total of 110 re-pregnant women who have received cesarean section and registered in the Obstetrics Clinic of Obstetrics and Gynecology Hospital of Fudan University from August to November 2018 were selected as the subjects by convenience sampling, and investigated by using a selfadministrated questionnaire on re-pregnant women’ willingness to select delivery modes after cesarean section. Results Of the 110 re-pregnant women who have received cesarean section, 54(49.09%) chose vaginal delivery, 46(41.82%) chose cesarean section, and 10(9.09%) were uncertain. The results of χ^2 test showed that there were differences in the willingness to choose delivery modes among re-pregnant women with different ages, registered residences, education levels, career, average monthly household income,reasons of cesarean section for the previous child, with or without chronic diseases before pregnancy, modes of delivery for the second child of friends, and perception of delivery modes(P <0.05). Conclusion Repregnant women who have received cesarean section are more willing to choose cesarean section. Medical staff should strengthen health education during their pregnancy, actively make use of their social support, and guide them to choose an appropriate mode of delivery, thus to reduce the rate of cesarean section without medical indications.