改良VBAC评分法对瘢痕子宫再妊娠产妇自然分娩成功率的预测价值研究  

Predictive value of modified VBAC scoring method for the success rate of natural childbirth in women with scar uterus repregnancy

作　　者：周爱红 杨菊芬 ZHOU Aihong;YANG Jufen(Department of Obstetrics,Wuwei People's Hospital,Wuwei,Gansu 733000,China;Department of Obstetrics and Gynecology,People's Hospital of Min Qin County,Wuwei City,JVuwei,Gansu 733300,China)

机构地区：[1]武威市人民医院产科,甘肃武威733000 [2]武威市民勤县人民医院妇产科,甘肃武威733000

出　　处：《中国优生与遗传杂志》2021年第4期542-545,共4页Chinese Journal of Birth Health & Heredity

基　　金：武威市科技计划项目(WW2001050)。

摘　　要：目的研究改良剖宫产后阴道分娩(VBAC)评分法对瘢痕子宫再妊娠产妇自然分娩成功率的预测价值研究。方法选取2018年1月—2019年12月武威市人民医院收治的瘢痕子宫产妇376例,分为瘢痕子宫组;同时选取于医院进行健康体检的非瘢痕子宫产妇376例,分为非瘢痕子宫组。建立改良VBAC评分系统,统计产妇产后出血率、新生儿窒息率、围生儿病死率、输血发生率、产妇疼痛程度、平均产程、住院天数、住院费用、产妇并发症和新生儿的情况。结果改良VBAC评分>23分产妇自然分娩率高于改良VBAC评分≤23分产妇,改良VBAC评分>23分产妇的自然分娩率高于剖宫产率;瘢痕子宫组产妇产后出血率、新生儿窒息率、围生儿病死率、输血发生率、产妇疼痛程度、平均产程、住院天数、住院费用大于非瘢痕子宫组;瘢痕子宫组孕妇并发症的总并发率和新生儿情况的总有效率高于非瘢痕子宫组(P<0.05)。结论改良评分法有较高的诊断预测价值,为临床工作提供指导性作用,产前做好预测评估,可有效地降低剖宫产率,对于瘢痕子宫妊娠患者,选择阴道分娩是一种安全可行的分娩方式,在产妇疼痛程度、病死率、子宫切除率、输血发生率、产后感染、住院时间及住院费用等方面均明显优于再次剖宫产,此法操作简单,成本低廉,是相对安全、有效、较经济的一种方法,使更多瘢痕子宫患者获益。Objective To study the predictive value of modified VBAC scoring method for the success rate of natural childbirth in women with scar uterus repregnancy.Methods Totally 376 women with scar uterus admitted to our hospital from January 2018 to December 2019 were selected and divided into scar uterus group.At the same time,376 women with non-scar uterus who underwent physical examination in our hospital were divided into the non-scar uterus group.An improved VBAC scoring system was established to calculate maternal postpartum hemorrhage rate,neonatal asphyxia rate,perinatal mortality rate,blood transfusion rate,maternal pain,average duration of labor,length of hospital stay,hospital cost,maternal complications and neonatal conditions.Results The improved VBAC score of>23 was higher than the improved VBAC score of≤23,and the improved VBAC score of>23 was higher than the cesarean section rate.The incidence of postpartum hemorrhage,neonatal asphyxia,perinatal mortality,blood transfusion,maternal pain,average labor course,length of hospital stay and hospitalization expenses in scar uterus group were higher than those in non-scar uterus group.The total complication rate of pregnant women and the total effective rate of newborns in scar uterus group were higher than those in non-scar uterus group,with statistically significant differences(P<0.05).Conclusion Improved evaluation method has higher diagnosis prediction value,provide guidance for clinical work,prenatal completes the predictive evaluation,which can effectively decrease the rate of cesarean delivery,for scar uterine pregnancy patients,choice of vaginal delivery is a safe and feasible mode of delivery,in the maternal pain degree,mortality,uterus resection rate,incidence of transfusion,postpartum infection,length of hospital stay and cost of hospitalization etc were significantly better than cesarean section again,this method is simple,low cost,is a relatively safe,effective,the economy of a kind of method,bring benefit to more patients with cicatricial uterus.

关 键 词：改良剖宫产后阴道分娩评分法 瘢痕子宫 再妊娠产妇 自然分娩 

分 类 号：R714.2[医药卫生—妇产科学]