初次剖宫产术后阴道分娩的产程特点及母婴结局研究  

Study on the Characteristics of Labor Process of Vaginal Birth after the First Cesarean Section and Its Outcome of Maternal and Infant

作　　者：阙华鑫 QUE Huaxin(Nansha Hospital,Guangzhou First People’s Hospital,Guangzhou 511458,China)

机构地区：[1]广州市第一人民医院南沙医院,广东广州511458

出　　处：《中外医学研究》2020年第32期162-164,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析初次剖宫产术后阴道分娩(vaginal birth after cesarean section,VBAC)的产程特点及母婴结局。方法:选取2019年1月-2020年1月笔者所在医院接治的106例初次VBAC产妇为观察组,选择同期分娩的106例初产妇、106例经产妇分别为对照1组、对照2组。分析三组产程特点及母婴结局。结果:三组第三产程时间比较差异无统计学意义(P>0.05),观察组第一产程、第二产程、总产程时间均短于对照1组,第二产程时间短于对照2组,差异均有统计学意义(P<0.05),观察组第一产程、总产程与对照2组比较差异无统计学意义(P>0.05);三组产后出血、胎盘早剥、胎盘粘连、胎盘残留发生率及新生儿窒息发生率、Apgar评分比较差异均无统计学意义(P>0.05),观察组会阴侧切发生率、胎儿窘迫发生率均高于对照2组,差异均有统计学意义(P<0.05)。结论:初次VBAC产妇的整体产程时间介于初产妇和经产妇之间,但接近经产妇,且VBAC未增加母婴不良结局,具有临床可行性。然而,实施VBAC前必须仔细筛选产妇,密切观察母婴状况,记录产程时间,积极处理异常情况,保障母婴安全。Objective:To analyze the characteristics of labor process of vaginal birth after first cesarean section(VBAC)and its outcome of maternal and infant.Method:A total of 106 first-time VBAC parities admitted to the author's hospital from January 2019 to January 2020 were selected as the observation group,while 106 primiparas and 106 multipara who delivered at the same time were selected as control group 1 and control group 2,respectively.The characteristics of labor process and maternal and infant outcomes were analyzed.Result:There was no statistically significant difference in the time of third labor among the three groups(P>0.05).The time of the first,second and total labor in the observation group was shorter than that in control group 1,and the time of the second labor was shorter than that in control group 2,the differences were statistically significant(P<0.05),there was no statistically significant difference between the observation group and the control group 2 in the first and total labor stages(P>0.05).There were no statistically significant differences in the incidence of postpartum hemorrhage,placental abruption,placental adhesion,placental residue,and neonatal asphyxia and Apgar score among the three groups(P>0.05).The incidence of perineal resection and fetal distress in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion:The overall labor process time of first-time VBAC mothers was between that of primipara and that of multipara,but close to that of multipara.Moreover,VBAC does not increase maternal and infant adverse outcomes,so it is clinically feasible.However,prior to the implementation of VBAC,pregnant women must be carefully screened,their maternal and infant conditions must be closely observed,the time of labor must be recorded,and abnormal situations must be actively handled to ensure the safety of mothers and infants.

关 键 词：初次剖宫产 阴道分娩 产程 母婴结局 

分 类 号：R714.4[医药卫生—妇产科学]