剖宫产术后再次妊娠分娩方式的研究  

Study on the way of pregnancy delivery after cesarean section

作　　者：贺巧云[1] He Qiaoyun(Department of Gynaecology and Obstetrics,the Eighth People＇s Hospital of Taiyuan,Taiyuan,Shanxi 030012,China)

机构地区：[1]太原市第八人民医院妇产科,山西省太原030012

出　　处：《中国基层医药》2018年第17期2253-2255,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨剖宫产术后再次妊娠产妇的最佳分娩方式。方法回顾性分析太原市第八人民医院2015年1月至2016年12月收治的2526例产妇的临床资料，剖宫产共971例，其中二次剖宫产367例（对照B组），剖宫产后阴道分娩604例（观察组）。另选择同期非瘢痕子宫妊娠经阴道分娩产妇186例（对照A组）。比较三组母婴结局。结果对照A组产程时间、产后出血量、住院时间、新生儿窒息发生率分别为（6．30±3．03）h、（288．67±220．67）mL、（1．37±0．72）d、3．76％，对照B组分别为（6．30±3．03）h、（415．87±356．20）mL、（4．32±0．83）d、3．54％，观察组分别为（5．98±2．87）h、（276．44±211．84）mL、（1．42±0．65）d、3．48％。对照B组产后出血量明显多于观察组[（415．87±356．20）mL比（276．44±211．84）mL]，差异有统计学意义（t=11，271，P〈0．05），住院时间明显长于观察组[（4．32±0．83）d比（1．42±0．65）d]，差异有统计学意义（t=18．034，P〈0．05）。结论在具备中转急诊剖宫产术的条件下，对符合阴道分娩条件的剖宫产再次妊娠产妇给予阴道试产是安全可行的。Objective To explore the choice of the best mode of delivery after cesarean section. Methods From January 2015 to December 2016,the clinical data of 2 526 pregnant women admitted in the Eighth People~ Hospital of Taiyuan were retrospectively analyzed. A total of 971 cases were cesarean section, among them, the second cesarean section in 367 cases （ control group B）, cesarean section vaginal delivery in 604 cases （ observation group ）. At the same period, another 186 cases with non - scar uterine pregnancy by vaginal delivery were selected as control group A. The maternal and child outcomes were compared among the three groups. Results The time of labor,postpartum hemorrhage, hospital stay, the incidence of neonatal asphyxia in the control group A were （ 6.30 ±3.03 ） h, （ 288.67 ±220.67 ） mL, （ 1.37 ±0.72） d,3.76%, respectively,which in the control group B were （6.30 ±3.03 ） h, （415.87 ±356.20 ） mL, （4.32 ±0.83 ） d, 3.54%, respectively, which in the observation group were （ 5.98 ±2.87 ） h, （ 276.44 ±211.84） mL, （ 1.42 ±0.65 ） d, 3.48 %, respectively. The postpartum hemorrhage of the control group B was significantly higher than that of the observation group[ （415.87 ±356.20） mL vs. （276.44 ±211.84） mL] ,the difference was statistically significant （t = 11.271, P 〈 0.05 ）. The length of hospital stay of the control group B was also longer than that of the observation group[ （4.32 ±0.83 ） d vs. （ 1.42 ±0.65 ） d], the difference was statistically significant（ t = 18. 034,P 〈 0.05 ）. Conclusion In the condition of emergency intercourse with cesarean section, it is safe and feasible to give the vagina trial to the pregnancy of cesarean section which meets the conditions of vaginal delivery.

关 键 词：剖宫产术 再 剖宫产后阴道分娩 妊娠结局 

分 类 号：R714.4[医药卫生—妇产科学]