剖宫产术后阴道分娩的产程观察及影响妊娠结局的相关因素分析  

Labor process of vaginal birth after cesarean and related factors affecting pregnancy outcome

作　　者：杨磊[1] 张云[1] 李亚 YANG Lei;ZHANG Yun;LI Ya(Department of Obstetrics and Gynecology,Bengbu First People s Hospital,Bengbu 233000,Anhui,China)

机构地区：[1]蚌埠市第一人民医院妇产科,安徽蚌埠233000

出　　处：《川北医学院学报》2023年第6期814-817,共4页Journal of North Sichuan Medical College

摘　　要：目的:观察剖宫产术后再次妊娠经阴道分娩(VBAC)的产程情况,并分析VBAC妊娠结局的影响因素。方法:选取80例剖宫产术后阴道试产(TOLAC)产妇为研究对象。根据分娩方式不同,将阴道试产成功者设为VBAC组(n=63),试产失败转剖宫产者设为重复剖宫产组(ERCS组,n=17)。统计VBAC组产程情况,比较两组产妇妊娠结局,运用Logistic回归分析影响TOLAC妊娠结局的相关因素。结果:VBAC组未出现产程延长的产妇。VBAC组产后2 h出血量、产后住院时间均低于ERCS组(P<0.05);VBAC组产妇年龄<35岁、生育间隔≥5年、宫颈Bishop评分≥7分、分娩孕周<40周、新生儿体重<3200 g等指标所占比率均高于ERCS组(P<0.05)。Logistic回归分析发现,宫颈Bishop评分≥7分、分娩孕周<40周、新生儿体重<3200 g是促使VBAC成功的有利因素(P<0.05)。结论:VBAC安全可行,产程延长风险低,且宫颈Bishop评分、分娩孕周、新生儿体重等因素为VBAC成功与否的影响因素。Objective:To observe the labor process of vaginal birth after cesarean(VBAC),and analyze and the influencing factors of pregnancy outcome of VBAC.Methods:A total of 80 women with trial of labor after cesarean delivery(TOLAC)were selected as the research subjects.Among them,63 women who underwent successful vaginal delivery were included in the VBAC group,and 17 women who underwent cesarean section after trial failure were included in the elective repeated cesarean section(ERCS)group.Labor duration in the VBAC group was counted,and the pregnancy outcomes in the VBAC group and ERCS group were compared.Logistic regression analysis was performed to screen related factors affecting the pregnancy outcomes of TOLAC.Results:There were no parturients with labor prolongation in the VBAC group.The 2 h postpartum bleeding volume and postpartum hospital stay of the VBAC group were smaller/shorter than those of the ERCS group(P<0.05).The proportions of women<35 years old,women with birth interval≥5 years,cervical Bishop score≥7,gestational age<40 weeks,and neonatal weight<3,200 g in the VBAC group were higher than those in the ERCS group.Logistic regression analysis found that cervical Bishop score≥7,gestational age<40 weeks,and neonatal weight<3,200 g were favorable factors for the success of VBAC(P<0.05).Conclusion:VBAC is safe and feasible,with low risk of labor prolongation.In addition,factors such as cervical Bishop score,gestational week of delivery,and neonatal weight are factors influencing the success of VBAC.

关 键 词：剖宫产术后 阴道分娩 产程观察 妊娠结局 影响因素 

分 类 号：R719.8[医药卫生—妇产科学]