影响瘢痕子宫再次妊娠经阴道分娩的相关因素分析  

Analysis of related factors influencing vaginal delivery of re-pregnant women with scar uterus

作　　者：任美[1] 何俐[1] 王珏辉[1] REN Mei;HE Li;WANG Jue-hui

机构地区：[1]郑州铁路职业技术学院

出　　处：《护理实践与研究》2019年第15期28-30,共3页Nursing Practice and Research

摘　　要：目的 探讨瘢痕子宫再次妊娠经阴道分娩的影响因素。方法 选取2016年2月至2018年12月在我院建档产检并分娩的瘢痕子宫再次妊娠孕妇226例作为研究对象。对孕妇的基本情况(年龄、文化程度、居住地)、孕期健康情况(孕周、孕期产检及保健、孕期增重、妊娠期糖尿病、孕前肥胖)、前次剖宫产情况(距离上次剖宫产时间、原切口长度)、心理状态、宫颈成熟度及新生儿体质量进行调查,采用多因素logistic回归分析瘢痕子宫再次妊娠经阴道分娩的影响因素。结果 226例瘢痕子宫再次妊娠经阴道分娩成功176例。年龄、孕期合理增重、妊娠期糖尿病、距离上次剖宫产时间、宫颈成熟度评分、抑郁情绪、焦虑情绪及新生儿体质量是瘢痕子宫再次妊娠经阴道分娩的相关因素(P<0.05);多因素logistic回归分析显示,孕期合理增重、距离上次剖宫产时间(≥4.2年)是瘢痕子宫再次妊娠经阴道分娩的保护因素(P<0.05),产妇抑郁情绪及新生儿体质量过大是影响瘢痕子宫再次妊娠经阴道分娩的独立危险因素(P<0.05)。结论 瘢痕子宫再次妊娠经阴道分娩的影响因素较多,应在孕期及围产期给予充分干预,维护产妇的心理健康,提高经阴道分娩的成功率。Objective To explore the influencing factors of vaginal delivery of re-pregnant women with scar uterus. Methods To select 226 re-pregnant women with scar uterus who set up the file of production inspection and delivered in our hospital from February 2016 to December 2018 as the study subjects. We investigated the basic conditions of these pregnant women (such as age, education, and place of residence), health during pregnancy (such as pregnancy, pregnancy check-up and health care, weight gain during pregnancy, gestational diabetes, and pre-pregnancy obesity), previous cesarean section (including time of the previous section and length of the previous incision), the mental state, the maturity of the cervix and the body weight of the newborn. Multivariate logistic regression analysis was used to analyze the influencing factors of vaginal delivery in re-pregnant women with scar uterus. Results Among the 226 cases of re-pregnant women with scar uterus who selected vaginal delivery, a total of 176 cases succeeded. The related factors for vaginal delivery of re-pregnant women with scar uterus included age, reasonable weight gain during pregnancy, gestational diabetes, period from last cesarean section, cervical maturity score, depression, anxiety and neonatal body mass( P <0.05). Multivariate logistic regression analysis showed that reasonable weight gain during pregnancy, and time of the last cesarean section (≥ 4.2 years) were protective factors for vaginal delivery of re-pregnant women with scar uterus( P <0.05). Maternal depression and excessive body mass of the newborn were independent risk factors affecting virginal delivery of re-pregnant women with scar uterus( P <0.05). Conclusion There are many factors influencing the vaginal delivery of re-pregnant women with scar uterus. We should provide fully intervention during pregnancy and perinatal period to maintain the mental health of the mother and improve the success rate of vaginal delivery.

关 键 词：瘢痕子宫 再次妊娠 阴道分娩 焦虑 抑郁 妊娠结局 

分 类 号：R473.71[医药卫生—护理学]