瘢痕子宫再次妊娠阴道试产246例临床分析

The Clinical Analysis of 246 Pregnant Women Trial Vaginal Delivery after Previous Caesarean Section

目的:总结瘢痕子宫再次妊娠阴道试产成功与失败的原因。方法:珠海市人民医院2014年2月至2016年8月共246例瘢痕子宫再次妊娠孕妇进行试产,以试产失败转剖宫产的孕妇为研究组(n=53),以阴道分娩成功的孕妇为对照组(n=193),比较两组孕妇的年龄、产前体重指数、头盆评分、宫颈评分、新生儿体重、产后出血量、住院天数。结果:与对照组比较,研究组孕妇年龄、产前体重指数明显高(均P<0.05),头盆评分显著低(P<0.01),新生儿体重显著重(P<0.01),产后出血量及住院天数均明显增多(均P<0.05)。结论:对瘢痕子宫孕妇严格孕期管理及控制胎儿体重,合理选择阴道试产孕妇,可提高瘢痕子宫再次妊娠阴道试产成功率,节省医疗资源。

Objective:To summarize the causes of success and failure in pregnant women trial of labor after previous caesarean section. Methods:The study was conducted at Zhuhai People′ s Hospital from Feb 2014 to Aug2016,a total of 246 pregnant women of scar uterine pregnancy carrying on trial of labor were included. 53 cases who had failed and applied secondary cesarean section were defined as study group,193 cases who had succeeded was defined as control group. The age of pregnant women,prenatal BMI,cephalopelvic score,bishop score,neonatal weight,postpartum haemorrhage,and hospital stays were compared between the two groups. Results: Compared with the control group,the age of pregnant women and prenatal BMI were significantly higher(P<0.05),cephalopelvic score was significantly lower(P<0.01),neonatal weight was significantly weighter(P<0.01),postpartum haemorrhage and hospital stays were significantly higher in study group(P<0.05). Conclusion:Strictpregnancy management,neonatal weight control,and appropriate selection of pregnant women with scar uterine can improve the success rate of vaginal delivery and save medical resources.