瘢痕子宫产妇年龄、分娩间隔时间与阴道试产结局的关联分析  

Correlation analysis of age and delivery interval with outcome of trial vaginal delivery in parturient women tients with scarred uterus

作　　者：金栩冰 张茜茜 王琴许 陈璐璐[1] 王连云[1] 王乐丹[1] JIN Xubing;ZHANG Qianqian;WANG Qinxu;CHEN Lulu;WANG Lianyun;WANG Ledan(Department of Gynecology and Obstetrics,The Second Affiliated Hospital of Wenzhou Medical University,Zhejiang Wenzhou 325027,China)

机构地区：[1]温州医科大学附属第二医院妇产科,浙江温州325027

出　　处：《中国妇幼健康研究》2023年第9期19-22,共4页Chinese Journal of Woman and Child Health Research

基　　金：国家自然科学基金资助项目(81803421);浙江省基础公益研究计划(LQ20C060003);温州市科技局基础性科研项目(Y20170611)。

摘　　要：目的考察瘢痕子宫产妇年龄、分娩间隔时间与阴道试产结局的关联性。方法选取2019年1月至2020年3月在温州医科大学附属第二医院产科接受阴道试产的112例瘢痕子宫产妇为研究对象。依据生产方式结局不同,分为经阴道分娩(n=82)与再次剖宫产(n=30)两个组别,分析并比较两组产妇并发症情况;受试者工作特征(ROC)曲线分析年龄、分娩间隔时间对阴道试产结局的预测价值。结果经阴道分娩的瘢痕子宫产妇并发症发病率低于再次剖宫产产妇,差异有统计学意义(1.22%vs.16.67%,χ^(2)=10.337,P<0.05);经阴道分娩的瘢痕子宫产妇年龄小于再次剖宫产产妇,分娩间隔时间长于再次剖宫产产妇,差异有统计学意义(t值分别为7.586、8.472,P<0.05);ROC曲线分析结果显示,年龄、分娩间隔时间预测瘢痕子宫产妇阴道试产结局的曲线下面积(AUC)分别为0.816、0.793,二者联合预测的AUC为0.878,联合预测的灵敏度为86.92%,特异度为84.13%。结论瘢痕子宫产妇再次剖宫产并发症较多,且再次剖宫产者年龄偏大、分娩间隔时间偏短。Objective To investigate correlations of age and delivery interval with outcome of trial vaginal delivery in women with scarred uterus.Methods 1l12 parturient women with cesarean scar pregnancy(CSP)who underwent trial vaginal delivery in The Second Affiliated Hospital of Wenzhou Medical University from January 2019 to March 2020 were selected as research subjects.Acording to delivery mode,the pregnant were divided into two groups:vaginal delivery group(n=82)and recurrent cesarean section group(n=3o).The complications of the parturient women in the two groups were analyzed and compared,and correlations of age and delivery interval with outcome of trial vaginal delivery of women with cesarean scar pregnancy were investigated.Results The incidence rate of complications in the recurrent cesarean section group was higher than that in the vaginal delivery group(1.22%us.16.67%,χ^(2)=10.337,P<0.05).The age of women undergoing vaginal delivery was significantly younger than that of women undergoing recurrent cesarean section,and delivery interval was significantly longer than that of women undergoing cesarean section(t=7.586 and 8.472 respectively,both P<0.05).The ROC curve analysis shown that the AUCs of age and delivery interval for predicting outcome of trial vaginal delivery of women with CSP were 0.816 and 0.793 respectively,which had certain predictive value for the outcome of trial vaginal delivery.The AUC of the joint prediction of the two was O.878,the sensitivity of the joint prediction was 86.92%,and the specificity was 84.13%.Conclusion The parturient women with CSP who undergo recurrent cesarean section have more complications,and they hand older age and longer delivery interval.

关 键 词：瘢痕子宫 年龄 分娩时间 阴道试产 

分 类 号：R173[医药卫生—妇幼卫生保健]