高龄孕产妇阴道试产失败的影响因素

Influencing factors of vaginal trial delivery failure in elderly pregnant women

目的探讨高龄孕产妇阴道试产失败的影响因素,旨在降低阴道试产失败率。方法选取2019年1月至2021年4月昆明医科大学第一附属医院收治的135例高龄孕产妇作为研究对象。统计阴道试产失败发生率,采用单因素、多因素分析高龄孕产妇阴道试产失败的影响因素。结果高龄孕产妇阴道试产失败发生率为22.96%(31/135),将患者纳入发生组(n=31),未发生试产失败的患者纳入未发生组(n=104),两组超重、剖宫产史、阴道试产史、妊娠高血压、妊娠糖尿病、预估胎儿体重、瘢痕子宫、入院宫颈Bishop评分比较,差异具有统计学意义(P<0.05)。超重、瘢痕子宫是高龄孕产妇阴道试产失败的高危因素,阴道试产史、入院宫颈Bishop评分≥4分是高龄孕产妇阴道试产失败的保护因素(P<0.05)。结论高龄孕产妇阴道试产失败受诸多因素影响,包括超重、瘢痕子宫、入院宫颈Bishop评分等,给予针对性的干预措施有助于降低阴道试产失败发生率。

Objective To explore the influencing factors of vaginal trial delivery failure in elderly pregnant women, in order to reduce the failure rate of vaginal trial delivery. Methods 135 cases elderly pregnant women admitted to the First Affiliated Hospital of Kunming Medical University from January 2019 to April 2021 were selected as the research objects. The incidence of vaginal trial delivery failure was counted, and the influencing factors of vaginal trial delivery failure in elderly pregnant women were analyzed by single factor and multi factor analysis. Results The incidence of vaginal trial delivery failure in elderly pregnant women was 22.96%(31/135), which was included in the occurrence group(n=31), and the vaginal trial delivery success was included in the non-occurrence group(n=104).There were significant differences between the two groups in terms of overweight, cesarean section, vaginal trial delivery history, gestational hypertension, gestational diabetes mellitus, estimated fetal weight, scarred uterus and admission cervical Bishop score(P<0.05).Overweight and scarred uterus are the high-risk factors of vaginal trial delivery failure in elderly pregnant women, while vaginal trial delivery history and admission cervical Bishop score ≥ 4 were the protective factors of vaginal trial delivery failure in elderly pregnant women(P<0.05). Conclusions The vaginal trial delivery failure of elderly pregnant women is affected by many factors, including overweight, scarred uterus, admission cervical Bishop score and so on. Giving targeted interventions will help to reduce the incidence of vaginal trial delivery failure.