剖宫产后瘢痕子宫再次妊娠不同分娩方式效果比较  

Comparison of Different Delivery Modes in Secondary Pregnant Women with Post-Cesarean Section Scarred Uterus

作　　者：陈志梅[1] CHEN Zhi-mei(Department of Obstetrics,Shenzhen Maternal and Child Health CareHospital,Shenzhen 518000,China)

机构地区：[1]深圳市妇幼保健院产科,广东深圳518000

出　　处：《实用临床医学（江西）》2019年第2期37-40,共4页Practical Clinical Medicine

摘　　要：目的比较不同分娩方式在剖宫产后瘢痕子宫再次妊娠中的应用效果。方法将766例剖宫产后瘢痕子宫再次妊娠产妇按分娩方式不同分为2组:试验组417例行阴道分娩,对照组349行剖宫产。比较2组产妇的产后出血量、产程时间、分娩后下床活动时间、首次排气时间、住院时间、新生儿体质量、新生儿Apgar评分及不良事件(先兆子宫破裂、产褥病、新生儿窒息率等)发生的情况,并采用医院自制满意度调查问卷对2组产妇及家属的满意度进行评价。结果试验组产后出血量、分娩后下床活动时间、首次排气时间、住院时间、新生儿体质量、先兆子宫破裂发生率及产褥病发生率均较对照组显著减少(P<0.05),产妇及家属满意度评分均较对照组显著增加(P<0.05);2组产程时间、新生儿Apgar评分及新生儿窒息发生率比较差异均无统计学意义(P>0.05)。结论对剖宫产后瘢痕子宫再次妊娠产妇,采用阴道分娩效果显著,可减少出血量、缩短住院时间、改善妊娠结局,且患者及家属的满意度高。Objective To compare the efficacies of different delivery modes in secondary pregnant women with post-cesarean section scarred uterus. Methods A total of 766 pregnant women with post-cesarean section scarred uterus were assigned to receive either vaginal delivery(experimental group, n =417) or cesarean section(control group, n =349).Postpartum hemorrhage,labor duration,time to out-of-bed activity,time to first flatus,hospital stay,birth weight,Apgar score and adverse events(uterine rupture,puerperal disease,neonatal asphyxia,etc.) were compared between the two groups.In addition,maternal and family satisfaction was assessed using the self-made questionnaire. Results Compared with control group,postpartum hemorrhage,time to out-of-bed activity,time to first flatus,length of hospital stay,birth weight,incidence of threatened uterine rupture and incidence of puerperalism decreased and maternal and family satisfaction increased in experimental group( P <0.05).There were no significant differences in labor duration,Apgar score and incidence of neonatal asphyxia between the two groups( P >0.05). Conclusion Vaginal delivery can reduce bleeding,shorten labor duration,improve pregnancy outcome and enhance maternal and family satisfaction in puerperae with post-cesarean section scarred uterus.

关 键 词：剖宫产后瘢痕子宫 妊娠 分娩方式 

分 类 号：R714[医药卫生—妇产科学]