瘢痕子宫再次妊娠经阴道分娩的可行性及安全性分析  

Feasibility and safety of vaginal delivery of scar uterus in pregnancy

作　　者：刘蓓 蔡锋成 朱立波[2] LIU Bei;CAI Fengcheng;ZHU Libo(Department of Obstetrics,Obstetrics and Gynecology Hospital of Hangzhou,Hangzhou 310008,China)

机构地区：[1]杭州市妇产科医院产科,浙江杭州310008 [2]杭州市第一人民医院产科

出　　处：《全科医学临床与教育》2018年第6期641-643,共3页Clinical Education of General Practice

基　　金：浙江省医药卫生科技计划项目(2015KYB307)

摘　　要：目的探讨瘢痕子宫再次妊娠经阴道分娩的可行性及安全性,为产科临床实践提供一定的参考。方法回顾性选择瘢痕子宫再次妊娠产妇100例,按照其分娩方式分为剖宫产组和阴道分娩组各50例,比较两组分娩时间、住院时间、出血量、婴儿Apgar评分、产后并发症(新生儿窒息、产后感染、产后大出血、尿潴留)等指标。结果两组产妇在分娩时间、婴儿Apgar评分方面比较,差异无统计学意义(t分别=1.32、1.50,P均>0.05),而阴道分娩组住院时间、出血量明显少于剖宫产组(t分别=2.91、3.25,P均<0.05)。阴道分娩组产褥感染发生率明显低于剖宫产组,差异具有统计学意义(χ2=3.79,P<0.05),两组新生儿窒息、产后大出血、尿潴留发生率之间比较,差异不具有统计学意义(χ2分别=1.01、0.69、0.51,P均>0.05)。剖宫产组产后总并发症发生率明显高于阴道分娩组(χ2=5.11,P<0.05)。结论瘢痕子宫再次妊娠经阴道分娩具备一定可行性,同时能够保障母婴安全。Objective To explore the feasibility and safety of vaginal delivery of scar uterus with second pregnancy, so as to provide reference for clinical practice. Methods A data of 100 pregnant women with scar uterus was retrospectively analyzed. According to the mode of delivery, they were divided into cesarean section group and vaginal delivery group. The delivery time, hospital stay, bleeding volume, infant Apgar score, postpartum complications（neonatal asphyxia, postpartum infection, postpartum hemorrhage, urinary retention）were compared between the two groups. Results There were no significant differences in delivery time and infant Apgar score between the two groups（t=1.32, 1.50, P〉0.05）, while the hospital stay and bleeding volume of vaginal delivery group were significantly less than those of cesarean section group（t=2.91,3.25,P〈0.05）. The incidence of puerperal infection of vaginal delivery group was significantly lower than that of cesarean section group （χ^2= 3.79, P〈0.05）. There were no significant differences in the incidence of neonatal asphyxia, postpartum hemorrhage and urinary retention between two groups（χ^2=1.01, 0.69, 0.51, P〉0.05）. The incidence of postpartum complications of cesarean section group was significantly higher than that of vaginal delivery group （χ^2=5.11, P〈0.05）. Conclusion The vaginal delivery of scar uterus with second pregnancy is feasible and can ensure the safety of mother and baby.

关 键 词：瘢痕子宫 阴道分娩 可行性 安全性 

分 类 号：R714.4[医药卫生—妇产科学]