剖宫产史孕妇再次妊娠分娩方式对母儿结局的影响  

The influence of different delivery mode of pregnant women with scar uterus on maternal and child outcomes

作　　者：卢晓宁[1] 李歧佩[1] 赵乃蒙[1] 冯晓珊 马文娟[1] LU Xiaoning;LI Qipei;ZHAO Naimeng;FENG Xiaoshan;MA Wenjuan(The Second Affiliated Hospital of Xi＇an Jiaotong University, Sanxi, 710004)

机构地区：[1]西安交通大学第二附属医院,710004

出　　处：《中国计划生育学杂志》2018年第6期483-486,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨瘢痕子宫孕妇不同分娩方式对母儿结局的影响。方法:回顾性收集236例在本院产科分娩的瘢痕子宫孕妇,根据分娩方式的不同分为瘢痕剖宫产组(168例,剖宫产分娩)与瘢痕阴道产组(68例,经阴道分娩)。另选取本院同期80例非瘢痕子宫孕妇,根据分娩方式的不同分为正常剖宫产组(37例,剖宫产分娩)和正常阴道产组(43例,经阴道分娩)。对比4组的出血量、住院时间及母儿结局。结果:瘢痕剖宫产组的术中出血量及产后出血率明显高于正常剖宫产组,手术时间明显长于正常剖宫产组(P<0.05),新生儿Apgar评分、住院时间比较两剖宫产组无差异(P>0.05)。瘢痕剖宫产组的出血量、产褥感染率及住院时间均高于瘢痕阴道产组(P<0.05),新生儿Apgar评分、新生儿窒息发生率瘢痕剖宫产组与瘢痕阴道产组比较无差异(P>0.05)。瘢痕阴道产组出血量、产程时间、新生儿Apgar评分、住院时间与正常阴道产组比较无差异(P>0.05)。结论:剖宫产有较高的出血风险,对于符合阴道试产条件的瘢痕子宫再妊娠孕妇,应鼓励产妇进行阴道试产,以降低产后出血、产褥感染风险。Objective： To investigate the influence of different delivery mode of pregnant women with scar uterus on maternal and child outcomes. Methods： 236 pregnant women with scar uterus who came to the second affiliated hospital of Xi＇an Jiaotong university for delivery were divided into group A （168 cases, cesarean delivery） and group B （68 cases, vaginal delivery） according to the different modes of delivery. At the same time, another 80 pregnant women without scar uterus were selected and were divided into group C （37 cases, cesarean delivery） and group D （43 cases, vaginal delivery） depending on the mode of delivery. The bleeding volume, length of stay, and maternal and child out- comes of women were compared among the four groups. Results.. The volume of intraoperative blood loss and rate of postpartum hemorrhage of women in group A were significantly higher than those in group C. The operation time of women in group A was significantly longer than that of women in group C （P〈0.05）. There was no significant difference in the neonatal Apgar score and length of stay of women between group A and group C （P〉0.05）. The bleeding volume and puerperal infection rate of women in group A were significantly higher than those of women in group B, and the length of hospital stay of women in group A was significantly longer than that of women in group B （P〈0.05）. There was no significant difference in the neonatal Apgar scores and neonatal asphyxia rate between group A and group B （P〈0.05）. There was no significant difference in bleeding volume, labor time, neonatal Apgar score and hospital stay between group B and group D （P〉0.05）. Conclusion： Caesarean section is a high risk factor for postpartum hemorrhage and infection, so pregnant women with scar uterus should be encouraged to try vaginal delivery to prevent postpartum hemorrhage and puerperal infection if they match vaginal delivery conditions.

关 键 词：瘢痕子宫 分娩方式 剖宫产 阴道试产 母儿结局 

分 类 号：R714.4[医药卫生—妇产科学]