瘢痕子宫足月妊娠合并子宫肌瘤孕妇阴道分娩的效果及安全性分析

Analysis of effect and safety of vaginal delivery in full-term pregnant women with scar uterus complicated with uterine fibroids

目的探讨瘢痕子宫足月妊娠合并子宫肌瘤孕妇阴道分娩的效果及安全性。方法69例瘢痕子宫足月妊娠合并子宫肌瘤孕妇,按分娩方式不同分为阴道试产组(35例)和剖宫产组(34例)。阴道试产组进行阴道试产分娩方式,剖宫产组进行剖宫产分娩方式。记录阴道试产组中转剖宫产率;比较两组产妇产后出血量、住院时间、新生儿Apgar评分及并发症发生情况。结果阴道试产组阴道试产成功34例(97.14%),中转剖宫产1例(2.86%)。阴道试产组产后出血量(155.86±50.23)ml少于剖宫产组的(248.63±53.69)ml,产后住院时间(3.16±0.43)d短于剖宫产组的(5.26±1.13)d,差异有统计学意义(P<0.05);阴道试产组新生儿Apgar评分(9.56±0.42)分与剖宫产组的(9.42±0.39)分比较,差异无统计学意义(P>0.05)。阴道试产组发症发生率17.14%与剖宫产组的14.71%比较,差异无统计学意义(P>0.05)。结论瘢痕子宫足月妊娠合并子宫肌瘤孕妇阴道分娩结局良好,有效降低了产后出血量,缩短了产后住院时间,且未增加分娩风险,应合理指导孕妇进行阴道试产,进而降低剖宫产术实施率。

Objective To discuss the effect and safety of vaginal delivery in full-term pregnant women with scar uterus complicated with uterine fibroids.Methods A total of 69 cases of full-term pregnant women with scar uterus complicated with uterine fibroids were divided into vaginal trial group(35 cases)and cesarean section group(34 cases)according to different delivery methods.The vaginal trial group received vaginal trial delivery,and the cesarean section group received cesarean section.The conversion rate of cesarean section in the vaginal trial group was recorded;the postpartum blood loss,hospitalization time,neonatal Apgar score and complications were compared between the two groups.Results In the vaginal trial group,34 cases(97.14%)were successful in vaginal delivery,and 1 case(2.86%)converted to cesarean section.The postpartum blood loss(155.86±50.23)ml in the vaginal trial group was less than(248.63±53.69)ml in the cesarean section group,and the postpartum hospitalization time(3.16±0.43)d was shorter than(5.26±1.13)d in the cesarean section group.All the differences were statistically significant(P<0.05).The neonatal Apgar score of the vaginal trial group was(9.56±0.42)points,which was not statistically significant compared with(9.42±0.39)points in the cesarean section group(P>0.05).The incidence of complications in the vaginal trial group was 17.14%,which was not statistically significant compared with 14.71%in the cesarean section group(P>0.05).Conclusion The results of vaginal delivery in full-term pregnant women with scar uterus combined with uterine fibroids are good,which can effectively reduce the postpartum blood loss,shorten the postpartum hospitalization timewithout increasing the risk of delivery.Therefore,it is necessary to reasonably guide the women to conduct vaginal trial delivery,thus reducing the rate of cesarean section.