剖宫产术后再妊娠孕妇分娩方式与结局变化趋势及相关影响因素

The change trend and related in fluencing factors of deliverymode and outcome in pregnant women after caesarean section

目的探讨剖宫产术后再妊娠孕妇分娩方式与结局变化趋势及相关影响因素。方法回顾性选取2018年11月-2019年11月该院剖宫产术后再妊娠产妇100例,依据分娩方式分为阴道试产组和再次剖宫产组各50例,统计分析两组产妇的并发症发生情况、产后出血量、住院时间及医疗费用,并分析剖宫产术后再妊娠孕妇分娩方式选择的态度相关影响因素。结果阴道试产组产妇的发热、恶露过长及子宫下段切口愈合不良发生率均显著低于再次剖宫产组(P<0.05),产后出血量显著少于再次剖宫产组(P<0.05),住院时间显著短于再次剖宫产组(P<0.05),医疗费用显著低于再次剖宫产组(P<0.05)。剖宫产术后再妊娠孕妇学历本科及以上、月收入3000元以上、产妇分娩意向剖宫产及医师分娩建议剖宫产选择态度评分分别显著高于学历大专及以下、月收入3000元及以下、产妇分娩意向阴道分娩及医师分娩建议阴道分娩(P<0.05)。Logistic回归分析显示,剖宫产术后再妊娠孕妇分娩方式选择态度相关影响因素包括学历、医师分娩建议(P<0.05)。结论剖宫产术后再妊娠孕妇阴道试产较再次剖宫产妊娠结局好,相关影响因素包括学历、医师分娩建议。

Objective To study the delivery modethe,change trend of outcome and related influencing factors of the pregnant women after caesarean section.Methods From November 2018 to November 2019,100 cases of repregnant women after cesarean section in our hospital were retrospectively selected,according to the mode of delivery,who were divided into two groups:vaginal trial groupand fepeated caesarean section group 50 cases in each group.The incidence of complications,postpartum bleeding,hospital stay and medical expenses were analyzed,and the influencing factors of the attitude of postcesarean section pregnant women were analyzed.Results The incidence of fever,excessive lochia length,and poor incision healing in lower uterine segment in the vaginal trial were significantly lower than that in the fepeated caesarean section group(P<0.05).The amount of postpartum bleeding of the vaginal trial group was significantly lower than that of the fepeated caesarean section group(P<0.05),the hospital stay was significantly shorter than that of the fepeated caesarean section group(P<0.05),and the medical cost was significantly lower than that of the fepeated caesarean section group(P<0.05).Pregnant women after caesarean section with a bachelor’s degree or above,monthly income of more than 3000 yuan,maternal intention to deliver cesarean section,and attitude score of cesarean section selection recommended by doctors were significantly higher than those with a college degree or below,monthly income of 3000 yuan or below,maternal intention to deliver vaginal delivery,and vaginal delivery recommended by doctors(P<0.05).Logistic analysis showed that the influencing factors of pregnant women after caesarean section choice of delivery mode attitude included education background and doctor’s advice on delivery(P<0.05).Conclusion Pregnancy mode of pregnant women after cesarean section,vaginal trial delivery is better than fepeated caesarean section pregnancy outcome,related factors include education,doctor’s advice on childbirth.