剖宫产术后再次妊娠经阴道分娩状况及影响因素分析

Analysis of vaginal delivery status and influencing factors of second pregnancy after cesarean section

目的:探讨剖宫产术后再次妊娠经阴道分娩状况及影响因素。方法:回顾性收集2021年1月至2024年1月期间在本院分娩的剖宫产术后再次妊娠产妇的临床资料。所有产妇均进行阴道试产,并根据最终产妇分娩方式的不同,将产妇分为经阴道分娩组(阴道试产成功,n=36)和剖宫产组(阴道试产失败转剖宫产,n=14)。收集比较两组的基线资料,分析比较导致产妇试产失败的独立危险因素。结果:本研究50例剖宫产术后再次妊娠产妇,经阴道试产成功率为72.00%(36/50),中转剖宫产率28.00%(14/50)。Logistic回归分析显示,孕期增重不合理、宫颈成熟评分<6分、妊娠间隔时间不足4y、胎儿双顶径过大、产妇情绪焦虑都是导致剖宫产再次妊娠产妇经阴道试产失败的独立危险因素。结论:剖宫产术后再次妊娠产妇经阴道分娩试产成功率为72.00%,孕期增重不合理、宫颈成熟评分<6分、妊娠间隔时间不足4y、胎儿双顶径过大、产妇情绪焦虑都是导致剖宫产再次妊娠产妇经阴道试产失败的独立危险因素。

Objective:To investigate the status and influencing factors of vaginal delivery in second pregnancy after cesarean section.Methods:The clinical data of pregnant women who gave birth after cesarean section in our hospital from January 2021 to January 2024 were retrospectively collected.All the women underwent vaginal trial labor,and according to the different delivery methods of the final women,the women were divided into vaginal delivery group(vaginal trial labor success,n=36)and cesarean section group(vaginal trial labor failure cesarean section,n=14).The baseline data of the two groups were collected and compared to analyze and compare the independent risk factors leading to maternal trial failure.Results:In this study,the success rate of vaginal trial delivery was 72.00%(36/50)and the rate of transfer cesarean section was 28.00%(14/50).Logistic regression analysis showed that unreasonable weight gain during pregnancy,cervical maturity score<6,gestation interval less than 4 years,fetal double parietal diameter too large,maternal emotional anxiety were all independent risk factors leading to vaginal trial failure.Conclusion:The success rate of vaginal trial delivery was 72.00%.Unreasonable weight gain during pregnancy,cervical maturity score<6,gestation interval less than 4 years,large fetal double parietal diameter and maternal emotional anxiety were all independent risk factors leading to vaginal trial failure.