系统化管理在瘢痕子宫孕妇阴道分娩中的应用  

TO EXPLORE EFFECT OF SYSTEMATIC MANAGEMENT IN VAGINAL DELIVERY OF PREGNANT WOMEN WITH SCAR UTERUS

作　　者：于树静[1] 冯小明[1] 杨俊红[1] 李莉 彭希 李楠楠 YU Shujing;FENG Xiaoming;YANG Junhong;LI Li;PENG Xi;LI Nannan(Tangshan Maternal and Child Health Hospital,Tangshan 063000,China)

机构地区：[1]河北省唐山市妇幼保健院,063000

出　　处：《中国煤炭工业医学杂志》2022年第1期73-76,共4页Chinese Journal of Coal Industry Medicine

基　　金：河北省卫生健康委员会科研课题(编号:20201480)。

摘　　要：目的探讨系统化管理在瘢痕子宫孕妇阴道分娩中的应用效果。方法观察组选取2019年7月—2020年6月在唐山市妇幼保健院规范孕检瘢痕子宫孕妇200例,采用进入瘢痕子宫系统化管理小组,服务对象成群,服务时间固定的方法。对照组收集2015年1月—12月在唐山市妇幼保健院规范孕检瘢痕子宫再次妊娠孕妇200例,采取围产保健门诊定期孕检方法。对二组临床分娩情况、新生儿体重、新生儿窒息情况、孕妇SAS、SDS评分、产程时间等分娩结局进行比较。结果二组在临床分娩情况中,观察组的阴道试产率、阴道试产成功率高、子宫破裂率低,均优于对照组,差异有统计学意义(P<0.05);新生儿出生时体重低于对照组,差异有统计学意义(P<0.05);新生儿1分钟Apgar评分、新生儿动脉脐血分析二组差异无统计学意义(P>0.05);分娩过程中的观察组焦虑抑郁状况明显优于对照组,差异有统计学意义(P<0.05);观察组在第一产程、第二产程所需时间均优于对照组,差异有统计学意义(P<0.05);第三产程时间比较差异无统计学意义(P>0.05)。结论通过对瘢痕子宫孕妇进行系统化的管理,提高瘢痕子宫阴道分娩的安全性、成功率,改善了瘢痕子宫再次妊娠分娩结局,具有较高的临床应用价值。Objective To explore the effect of systematic management in vaginal delivery of pregnant women with scar uterus.Methods The observation group selected two hundred pregnant women with scar uterus who underwent standardized pregnancy examination in Tangshan maternal and child health hospital from July 2019 to June 2020,and adopted the method of entering the systematic management group of scar uterus, groups of service objects and fixed service time.The control group retrospectively collected 200 pregnant women with scar uterus who were pregnant again in Tangshan maternal and child health hospital from January 2015 to December 2015,and adopted the traditional random pregnancy test method.The clinical delivery, neonatal weight, neonatal asphyxia, SAS,SDS score, duration of labor and other delivery outcomes were compared between the two groups.Results in the clinical delivery of the two groups, the vaginal trial delivery rate, the success rate of vaginal trial delivery and the uterine rupture rate of the observation group were higher than those of the control group, and the difference was statistically significant(P<0.05);The birth weight of newborns was lower than that of the control group(P<0.05);There was no significant difference in Apgar score and umbilical cord blood analysis between the two groups(P>0.05);The state of anxiety and depression in the observation group was significantly better than that in the control group(P<0.05);The time required for the first stage of labor and the second stage of labor in the observation group were better than those in the control group, and the difference was statistically significant(P<0.05);There was no significant difference in the time of the third stage of labor(P>0.05);Conclusion through the systematic management of pregnant women with scar uterus, the safety and success rate of vaginal delivery with scar uterus can be improved, and the outcome of re pregnancy and delivery with scar uterus can be improved.It has high clinical value.

关 键 词：系统化管理 瘢痕子宫 阴道分娩 分娩结局 

分 类 号：R71[医药卫生—妇产科学]