瘢痕子宫再次妊娠阴道分娩自然临产与引产的成功率比较

Comparison of the Success rate of natural labor and Induced labor in Vaginal delivery of Re-pregnancy with scar uterus

目的探讨瘢痕子宫再次妊娠阴道分娩自然临产与引产的成功率。方法选取100例仅有1次剖宫产史再次妊娠的产妇,采用前瞻性队列研究方法,自然临产的60例产妇作为甲组,有引产指征实施引产的40例产妇作为乙组,比较两组产妇试产成功率、相关并发症发生情况、产后24 h出血量、产前及产后血红蛋白水平。结果甲组阴道试产成功率为81.67%,显著高于乙组的55.00%,差异具有统计学意义(P<0.05)。两组产妇产后出血、先兆子宫破裂、胎儿窘迫及新生儿窒息发生率比较,差异无统计学意义(P>0.05)。两组产妇产后24 h出血量、产前及产后血红蛋白水平比较,差异无统计学意义(P>0.05)。结论瘢痕子宫再次妊娠的产妇经阴道分娩自然临产成功率较高,且不会增加产后出血及各种并发症发生风险,保障母婴安全的前提下,产妇可根据自身实际情况选择适宜的分娩方式,提升试产成功率。

Objective To investigate the success rate of natural labor and labor induction in vaginal delivery of re-pregnancy with scar uterus.Methods select 100 cases of scar uterus pregnancy again,prospectie cohort study method,the natural labor of 60 cases of maternal as a first division,implementation with induced labor indicators induced labor of 40 cases of maternal as group b,comparing two groups of maternal trial-produce the success rate and related complications,24 h postpartum haemorrhage amount,prenatal and postpartum hemoglobin levels.Results The success rate of vaginal trial labor in group A was 81.67%,significantly higher than that in group B(55.00%),and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of postpartum hemorrhage,threatened uterine rupture,fetal distress and neonatal asphyxia between 2 groups(P>0.05).There was no significant difference in postpartum 24 h blood loss,prenatal and postpartum hemoglobin levels between 2 groups(P>0.05).Conclusion The success rate of natural labor through vaginal delivery of re-pregnancy with scar uterus is higher,and it does not increase the risk of postpartum bleeding and various complications.The puerpera can choose the appropriate delivery mode according to their own actual situation,and improve the success rate of trial labor on the premise of ensuring the safety of mother and child.