高龄产妇剖宫产后阴道试产失败原因及影响因素分析

Causes and influencing factors of failed trial of labour after caesarean section in elderly parturients

目的探讨高龄产妇剖宫产后阴道试产(TOLAC)失败原因及影响因素。方法回顾性分析200例TOLAC高龄产妇临床资料,用Logistic回归分析TOLAC失败影响因素。结果高龄产妇TOLAC失败率占30.0%,失败原因包括胎儿宫内窘迫(66.7%)、相对头盆不称(13.3%)、先兆子宫破裂(11.7%)、产时发热(8.3%)。年龄>40岁、分娩前体质量指数、新生儿体质量、阴道分娩史、临产时子宫颈Bishop评分是TOLAC失败的独立影响因素(P<0.05)。结论高龄产妇TOLAC最常见失败原因是胎儿宫内窘迫,影响因素包括年龄>40岁、分娩前体质量指数、新生儿体质量、阴道分娩史和临产时子宫颈Bishop评分。

Objective To investigate the causes and influencing factors of failed trial of labor after cesarean section(TOLAC)in elderly parturients.Methods Clinical data of 200 elderly parturients were retrospectively analyzed.The influencing factors of failed TOLAC were analyzed by logistic regression.Results The failure rate of TOLAC was 30.0%,and its causes included intrauterine fetal distress(66.7%),relative cephalopelvic disproportion(13.3%),threatened uterine rupture(11.7%),and intrapartum fever(8.3%).Age>40 years,body mass index,neonatal body weight,previous vaginal delivery,and Bishop score were the independent influencing factors for failed TOLAC(P<0.05).Conclusion Theintrauterine fetal distress is the most common cause of failed TOLAC in elderly parturients,and its influencing factors include age>40 years,body mass index,neonatal body weight,previous vaginal delivery,and Bishop score.