剖宫产术后再次妊娠分娩方式的选择

Choice of Delivery Mode of Second Pregnancy after Cesarean Section

目的探究剖宫产术后再次妊娠的分娩方式选择。方法选择2018年3月至2019年3月间厦门市第五医院接收的剖宫产术后再次妊娠有阴道分娩适应证的孕妇198例进行研究,依据最终分娩方式的不同分成阴道分娩组68例,急诊剖宫产组32例,择期剖宫产组98例,比较3组的母婴结局。结果急诊剖宫产组及择期剖宫产组出血量及住院时间均高于阴道分娩组,差异显著(P<0.05);择期剖宫产组新生儿体质量明显高于阴道分娩组、急诊剖宫产组,差异显著(P<0.05);急诊剖宫产组及择期剖宫产组出血量及住院时间无明显差异(P>0.05);3组在新生儿Apgar评分、产后感染和子宫破裂方面差异不明显(P>0.05)。结论在严格掌握剖宫产术后再次妊娠阴道试产适应证及禁忌证的前提下,对于剖宫产术后再次妊娠有阴道分娩适应证的孕妇,可依据其具体情况优先选择阴道试产,有助于减少重复剖宫产及其母婴并发症。

Objective To explore the choice of delivery mode of second pregnancy after cesarean section.Methods All 198 pregnant women with indications for vaginal delivery who were pregnant again after cesarean section in Xiamen fifth hospital from March 2018 to March 2019 were selected for study.According to different final delivery methods,they were divided into 68 cases in vaginal delivery group,32 cases in emergency cesarean section group and 98 cases in elective cesarean section group.The maternal and infant outcomes of the three groups were compared.Results The bleeding volume and hospital stay in emergency cesarean section group and elective cesarean section group were significantly higher than those in vaginal delivery group(P<0.05).The body mass of newborns in elective cesarean section group was significantly higher than that in vaginal delivery group and emergency cesarean section group(P<0.05).There was no significant difference in bleeding volume and hospital stay between emergency cesarean section group and elective cesarean section group(P>0.05).There was no significant difference in neonatal Apgar score,postpartum infection and uterine rupture among the three groups(P>0.05).Conclusion On the premise of strictly mastering the indications and contraindications of vaginal trial delivery of second pregnancy after cesarean section,for pregnant women with indications of vaginal delivery of second pregnancy after cesarean section,vaginal trial delivery can be selected first according to their specific conditions,which is helpful to reduce repeated cesarean section and its maternal and infant complications.