剖宫产术后再次妊娠分娩方式临床分析  

Clinical analysis of delivery modeof repeated pregnancy after cesarean section

作　　者：黄文[1] 冯少谭[1] 罗沛芬[1] 

机构地区：[1]东莞市人民医院妇产科,广东523000

出　　处：《齐齐哈尔医学院学报》2013年第5期689-690,共2页Journal of Qiqihar Medical University

摘　　要：目的探讨行剖宫产术后再次怀孕产妇分娩方式选择,并比较分娩效果。方法回顾性分析我院2011年5月至2012年1月收治剖宫产术后再次怀孕产妇124例临床资料,其中71例产妇行剖宫产分娩,设为剖宫产分娩组;53例产妇行阴道试产,设为阴道分娩组;比较两组产妇新生儿窘迫、新生儿死亡、产后出血、术后严重黏连及子宫破裂等围手术期指标,并分析阴道试产产妇分娩结局。结果两组产妇均无新生儿死亡及子宫破裂发生。两组产妇新生儿窘迫、新生儿死亡、产后出血及子宫破裂发生率组间比较无显著差异(P>0.05);同时剖宫产组产妇术后严重黏连发生率明显高于阴道分娩组(P<0.05);行阴道分娩53例产妇试产成功48例,试产成功率为90.6%;阴道试产失败5例,其中1例子宫先兆破裂,2例宫缩乏力,1例胎儿宫内窘迫,1例主动要求改为剖宫产分娩。结论剖宫产并非行剖宫产术后再次怀孕产妇唯一分娩方式;在严密产前体格、影像学检查及全产程系统监护条件下,对于符合阴道试产剖宫产术后再次怀孕产妇可行阴道分娩。Objective To investigate the delivery mode of repeated pregnancy after cesarean section, and compare their effect. Methods Retrospective analysis ofclinical informationof 124 cases after cesarean sectionadmitting to our hospital fromMay, 2011 toJanuary, 2012, including 71 cases of parturients cesarean delivery, as cesarean delivery group; 53 cases of vaginal delivery of maternal line, as the vaginal delivery group; compared two groups of maternal neonatal distress, postpartum hemorrhage, neonatal death, severe postoperative adhesions and uterine rupture during operation period index, and analyzed the vaginal delivery outcome. Results The two groups had no neonatal mortality and maternal uterine rupture. Two groups of maternal neonatal distress, neonatal death, postpartum hemorrhage and the incidence of uterine rupture had no significant difference （P 〉 0. 05 ）; at the same time cesarean section parturient after severe adhesions had a significantly higher incidence than vaginal delivery group （ P 〈 0. 05 ） ; in53 casesof vaginal delivery, 48 cases of maternal trial production succeeded, the success rate was 90.6% ; 5 casesfailed invaginal trial production, including 1 cases of threatened rupture of uterus, 2 cases of uterine atony, 1 cases of fetal distress, 1 cases of active demand to cesarean delivery. Conclusions cesarean section is not the only delivery mode of repeated pregnancy after cesarean section ; Under the monitoring conditionsof prenatal physical and radiological examination as well as the entire production process, if their conditions comply with the vaginal delivery after cesarean section, the re - pregnantwomen canconduct vaginal delivery.

关 键 词：剖宫产 再次妊娠 分娩方式 结局 

分 类 号：R719.8[医药卫生—妇产科学]