瘢痕子宫再次妊娠阴道分娩的安全性分析

Safety analysis of vaginal delivery in re-pregnancy of scarred uterus

目的探讨瘢痕子宫再次妊娠阴道分娩的安全性及阴道试产的适应证。方法选取200例瘢痕子宫再次妊娠产妇,根据分娩方式不同分为对照组和观察组,每组100例。对照组行剖宫产,观察组行阴道分娩。比较两组住院时间、产后出血量、新生儿Apgar评分、新生儿出生体质量、产后并发症发生情况。结果观察组住院时间(3.14±0.59)d短于对照组的(5.31±1.07)d,产后出血量(95.53±10.38)ml少于对照组的(191.87±11.32)ml,新生儿Apgar评分(9.25±0.38)分高于对照组的(7.39±1.24)分,差异具有统计学意义(P<0.05);两组新生儿出生体质量比较差异无统计学意义(P>0.05)。观察组产后并发症发生率为2.0%,低于对照组的19.0%,差异有统计学意义(P<0.05)。结论瘢痕子宫再次妊娠产妇行阴道分娩具有较高的成功率和安全性,且母婴结局良好,因而需鼓励具有适应证的瘢痕子宫孕妇积极接受阴道分娩。

Objective To discuss the safety of vaginal delivery in re-pregnancy of scarred uterus and the indicators of vaginal trial production. Methods A total of 200 pregnant women with scarred uterus were divided into control group and observation group according to different delivery methods, with 100 cases in each group. The control group received cesarean section, and the observation group received vaginal delivery. The hospitalization time, amount of postpartum hemorrhage, neonatal Apgar score, neonatal birth weight, and occurrence of postpartum complications were compared between the two groups. Results The hospitalization time(3.14±0.59) d of the observation group was shorter than(5.31±1.07) d of the control group, and amount of postpartum hemorrhage(95.53±10.38) ml was less than(191.87±11.32) ml of the control group, and neonatal Apgar score(9.25±0.38) points was higher than(7.39±1.24) points of the control group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in neonatal birth weight between the two groups(P>0.05). The incidence of postpartum complications of the observation group was 2.0%, which was lower than 19.0% of the control group, and the difference was statistically significant(P<0.05). Conclusion Vaginal delivery with scarred uterus has a higher success rate and safety, and the maternal and infant outcome is good, so pregnant women with indications should be encouraged to actively accept vaginal delivery.