剖宫产术后瘢痕子宫再妊娠分娩结局回顾性分析  

Retrospective analysis of the outcome of re-pregnancy with scar uterus after cesarean section

作　　者：陈关凤 刘颖菊 蓝明永 张丽英 许丽湖 阮和云[1] CHEN Guan-feng;LIU Ying-ju;LAN Ming-yong;ZHANG Li-ying;XU Li-hu;RUAN He-yun(Department of Obstetricss,National Hospital Affiliated of Guangxi Medical University, Nangning 530001, China)

机构地区：[1]广西医科大学附属民族医院产科,广西南宁530001

出　　处：《武警后勤学院学报（医学版）》2018年第9期761-764,共4页Journal of Logistics University of PAP（Medical Sciences）

基　　金：广西崇左市科技计划项目(崇科攻11031230)

摘　　要：【目的】探讨剖宫产后瘢痕子宫再妊娠产妇阴道分娩的临床结局及安全性和可行性。【方法】回顾性分析2017年9月至2017年12月我院产科290例剖宫产术后瘢痕子宫再妊娠产妇的临床资料,按最终不同分娩方式分为阴道分娩组及剖宫产组,并以同时间段内非瘢痕子宫剖宫产及阴道分娩者为对照组,比较分析上述产妇一般资料及分娩结局指标。【结果】比较瘢痕子宫再妊娠不同分娩方式,阴道分娩组产妇的瘢痕厚度及距离前次剖宫产时间高于剖宫产组(P<0.05);阴道分娩组的出血量、产褥感染率及住院时间明显低于再次剖宫产组(P<0.05),并且与非瘢痕子宫阴道分娩组无显著差异(P>0.05);新生儿体质量、Apgar评分及窒息率与再次剖宫产组和非瘢痕子宫阴道分娩组均无显著差异(P>0.05)。【结论】瘢痕子宫再妊娠产妇采取阴道分娩可减少出血,缩短住院时间,降低母婴并发症的发生,具有较高安全性和可行性,值得临床推广。【Objective】To investigate the clinical outcome, safety and feasibility of vaginal delivery in re-pregnancy women with scar uterus after cesarean section.【Methods】The clinical data of 290 re-pregnancy women with scar uterine after cesarean section were retrospectively analyzed from September 2017 to December 2017 in our obstetrics, which were divided into vaginal delivery group and cesarean section group according to the final mode of delivery. At the same time, patients undergoing cesarean section with non-scarred uterine and vaginal delivery were selected as the control group. The general information and delivery outcome were compared.【Results】According to the different modes of delivery with scar uterus, the thickness of scar and the time distance from the previous cesarean section in the vaginal delivery group were more than those in the cesarean section (P<0.05). The amount of bleeding, the incidence of puerperal infection and length of hospitalization in the vaginal delivery group were significantly less than those in the cesarean section (P<0.05). However, they showed no significant difference between the vaginal delivery group and the non-scarred vaginal delivery group (P>0.05). Neonatal weight, Apgar score and asphyxia rate showed no significant difference between re-cesarean section and non-scarred vaginal delivery group (P>0.05).【Conclusion】Vaginal delivery in re-pregnancy women with scar uterus can reduce bleeding, shorten the length of hospitalization and reduce the incidence of maternal and infant complications. It is of high safety and feasibility and worthy of clinical popularization.

关 键 词：瘢痕子宫 再妊娠 剖宫产 阴道分娩 

分 类 号：R719.8[医药卫生—妇产科学]