剖宫产术后再次妊娠孕妇阴道分娩成功的影响因素分析

Analysis of the factors influencing the success of vaginal delivery in pregnant women with re pregnancy after cesarean section

目的分析剖宫产术后再次妊娠孕妇阴道分娩成功的影响因素。方法回顾性分析120例剖宫产术后再次妊娠分娩孕妇的资料,其中阴道分娩成功(阴道分娩成功组)74例,阴道分娩失败(阴道分娩失败组)46例。分析剖宫产术后再次妊娠孕妇阴道分娩成功的影响因素。结果阴道分娩成功组的年龄、分娩孕周、体质量指数、新生儿出生体重小于阴道分娩失败组,有阴道分娩史占比、Bishop宫颈成熟度评分≥6分占比高于阴道分娩失败组,差异具有统计学意义(P<0.05)。两组距离上次剖宫产时间、切口瘢痕厚度比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,年龄、Bishop宫颈成熟度评分、体质量指数、分娩孕周、新生儿出生体重、阴道分娩史是剖宫产术后再次妊娠孕妇阴道分娩成功的独立影响因素(OR=1.439、0.517、2.019、2.006、0.788、1.399,P<0.05)。结论剖宫产术后再次妊娠孕妇阴道分娩需要积极了解孕妇的基本情况,包括年龄、分娩孕周、Bishop宫颈成熟度评分、预估胎儿体重大小等情况,于分娩前予以关注,有助于提高剖宫产术后再次妊娠孕妇阴道分娩成功率,改善母婴结局,提高产妇分娩质量。

Objective To analyze the factors influencing the success of vaginal delivery in pregnant women with re pregnancy after cesarean section.Methods The clinical data of 120 pregnant women with re pregnancy after cesarean section were analyzed retrospectively,including 74 cases of successful vaginal delivery(successful vaginal delivery group)and 46 cases of failed vaginal delivery(failed vaginal delivery group).The factors influencing the success of vaginal delivery in pregnant women with a second pregnancy after cesarean section.Results In successful vaginal delivery group,the age,gestational age at delivery,body mass index,and birth weight of newborns were lower than those in the failed vaginal delivery group,and the proportion of having a history of vaginal delivery,and the Bishop cervical maturity score≥6 points were higher than those in the failed vaginal delivery group.All the differences were statistically significant(P<0.05).There was no statistically significant difference in the time to last cesarean section and incisional scar thickness between the two groups(P>0.05).Multivariate Logistic regression analysis showed that age,Bishop cervical maturity score,body mass index,gestational age at delivery,birth weight of newborns,and history of vaginal delivery were the independent influencing factors for successful vaginal delivery in pregnant women with re-pregnancy after cesarean section(OR=1.439,0.517,2.019,2.006,0.788,1.399;P<0.05).Conclusion Vaginal delivery of pregnant women after cesarean section requires active understanding of the basic situation of pregnant women,including age,gestational age at delivery,Bishop cervical maturity score,and estimation of fetal weight.It is helpful to pay attention to it before delivery,which will help to improve the success rate of vaginal delivery of pregnant women after cesarean section,improve the outcome of mother and baby,and improve the quality of maternal delivery.