瘢痕子宫妊娠阴道分娩的结局及临床分析

Outcome and clinical analysis of vaginal delivery in pregnancy with scarred uterus

目的探讨瘢痕子宫产妇再妊娠经阴道分娩的临床安全性及分娩结局。方法选取2020年2月至2021年2月广州市花都区第二人民医院妇产科收治的60例瘢痕子宫再妊娠产妇,有30例产妇采取经阴道自然分娩,将其纳入研究组;有30例产妇采取剖宫产分娩,将其纳入对照组。分析瘢痕子宫再妊娠产妇围手术期指标及母婴结局情况。结果研究组产时出血量、产后2 h出血量均较对照组少,住院时间较对照组短(P<0.05);研究组新生儿Apgar评分较对照组高(P<0.05);研究组产后出血、子宫破裂、产褥感染总发生率较对照组低(P<0.05);两组新生儿结局比较,差异无统计学意义(P>0.05)。结论瘢痕子宫产妇再妊娠经阴道分娩具有较为理想的可行性,在明确产妇符合瘢痕子宫行阴道分娩指征后采取经阴道分娩可减少术后并发症,降低剖宫产率,安全性良好。

Objective To investigate the clinical safety and delivery outcomes of vaginal delivery for re-pregnancy in women with scarred uterus.Methods A total of 60 cases of re-pregnancy with scar uterus who were treated in the Department of Obstetrics and Gynecology,the Second People’s Hospital of Huadu,Guangzhou from February 2020 to February 2021 were selected,and 30 cases of spontaneous vaginal delivery were included in the study group,30 cases of uterine delivery were included in the control group.Maternal perioperative indicators and maternal and infant outcomes of the re-pregnancy with scar uterus were analyzed.Results The intrapartum blood loss and 2 h postpartum blood loss in the study group were less than those in the control group,and the hospital stay was shorter than that in the control group(P<0.05).The Apgar score of neonates in the study group was higher than that in the control group(P<0.05).The total incidence of postpartum hemorrhage,uterine rupture and puerperal infection in the study group was lower than that in the control group(P<0.05).There was no significant difference in neonatal outcomes between the two groups(P>0.05).Conclusion Transvaginal delivery for re-pregnancy in women with scar uterus has an ideal feasibility.Vaginal delivery can reduce postoperative complications and cesarean section rate with good safety after the indication of vaginal delivery in scarred uterus is clearly met.