瘢痕子宫再次妊娠时分娩方式选择的分析和探讨  

Analysis and discussion on the choice of delivery mode for scar uterus during second pregnancy

作　　者：李小红[1] 刘彩莹 LI Xiaohong;LIU Caiying(Department of Gynecology, Maoming People＇s Hospital, Guangdong, Maoming 525000, China;Department of Obstetrics, Maoming People＇s Hospital, Guangdong, Maoming 525000, China)

机构地区：[1]广东省茂名市人民医院妇科,广东茂名525000 [2]广东省茂名市人民医院产科,广东茂名525000

出　　处：《中国医药科学》2018年第8期73-75,共3页China Medicine And Pharmacy

摘　　要：目的探讨瘢痕子宫再次妊娠时分娩方式的选择。方法采用随机数字表随机选取2017年3~6月在我院住院分娩的瘢痕子宫再次妊娠待产产妇153例,对其临床资料进行回顾性分析,对选择阴道试产和择期剖宫产两种分娩方式的产妇情况及新生儿情况进行观察比较。结果阴道试产108例,成功52例,阴道分娩组产妇在产后出血量及住院时间明显少于剖宫产组产妇,其差异具有统计学意义(P<0.05);阴道试产成功的新生儿Apgar<7分的比例较阴道试产失败和择期剖宫产,其差异无统计学意义(P>0.05);试产失败转急诊剖宫产的56例孕妇,术后的出血量及术后感染的发生率明显高于择期剖宫产组,其差异有统计学意义(P<0.05);阴道试产失败组的新生儿体重明显高于阴道试产成功组,差异有统计学意义(P<0.05)。结论阴道分娩的病症少,对瘢痕子宫再次妊娠孕妇具体状态和适应证进行谨慎评估后,仍然可以选择阴道试产。Objective To explore the choice of delivery mode for scar uterus during second pregnancy. Methods One hundred and fifty-three pregnant women of uterine scar pregnancy from March 2017 to June 2017 in our hospital were randomly selected, and the clinical data were retrospectively analyzed. Maternal and neonatal conditions of pregnant women with the choice of vaginal trial production and selective cesarean section were observed and compared. Results There were 108 cases of vaginal trial production and 52 cases were successful. The amount of postpartum hemorrhage and the time of hospitalization in the vaginal delivery group were significantly less than those in the cesarean section group. The difference was statistically significant（P 0.05）. The proportion of Apgar 7 in the successful vaginal birth test was not significantly different from that in the failed vaginal delivery trial and in the selective cesarean section（P 0.05）. In 56 cases of pregnant women who failed in the emergency cesarean section, the amount of bleeding and the incidence of postoperative infection were significantly higher than those of the elective cesarean section（P 0.05）. The birth weight of the failed vaginal delivery group was significantly higher than that of the successful vaginal delivery group（P 0.05）. Conclusion Vaginal delivery has fewer symptoms. After careful assessment of the specific state and indications of pregnant women with scar uterus, they can still choose vaginal trial production.

关 键 词：瘢痕子宫 阴道试产 再次剖宫产 新生儿情况 

分 类 号：R714.4[医药卫生—妇产科学]