剖宫产术后再次妊娠阴道分娩成功的影响因素及母婴结局分析

发布时间：2018-04-04 11:45

本文选题：剖宫产术　切入点：再次妊娠　出处：《中国现代医生》2016年35期

【摘要】：目的探讨剖宫产术后再次妊娠经阴道分娩成功的影响因素,并对产后母婴结局进行分析。方法选取2013年3月~2015年11月本院产科收治的剖宫产术后再次妊娠行阴道试产的125例产妇,其中成功阴道分娩65例,选取60例作为观察组,试产失败行剖宫产分娩60例作为对照组,经单因素和多因素Logistic回归分析比较两组研究因素的差异,并对两组母婴结局进行对比分析。结果单因素分析显示两组在家属态度、孕周、有否胎膜破裂、宫高、胎儿腹围及双顶径、胎头方位、Bishop宫颈成熟度评分、两次妊娠间隔时间、阴道分娩史方面差异有统计学意义(P0.05);多因素Logistic回归分析显示孕周、胎儿腹围、Bishop评分及胎头方位四个因素方面差异有统计学意义(P0.05);两组产后2 h及24 h出血量、产后住院时间方面差异有统计学意义(P0.05),两组子宫破裂率差异无统计学意义(P0.05);两组新生儿在窒息率、新生儿Apgar评分、住院率方面无显著差异(P0.05)。结论对剖宫产术后再次妊娠的孕妇进行产前能否经阴道分娩的评估,若孕妇未出现剖宫产指征,可在严密监护和多次评估后,指导产妇进行阴道分娩,以降低对母婴身心健康的影响,提升母婴生存质量。
[Abstract]:Objective to investigate the factors influencing the success of vaginal delivery after cesarean section and to analyze the outcome of postpartum pregnancy.Methods from March 2013 to November 2015, 125 pregnant women who underwent vaginal trial delivery after cesarean section from March 2013 to November 2015 were selected, including 65 cases of successful vaginal delivery and 60 cases of observation group.Sixty cases of cesarean section were used as the control group. The difference of the two study factors was compared by univariate and multivariate Logistic regression analysis, and the outcomes of the two groups were compared and analyzed.Results univariate analysis showed that in the two groups, family attitude, gestational weeks, rupture of membranes, uterine height, fetal abdominal circumference and biparietal diameter, fetal head orientation, Bishop cervical maturity score, and interval between two pregnancies were observed.There were significant differences in the history of vaginal delivery (P 0.05), multivariate Logistic regression analysis showed that there were significant differences in the four factors of gestational week, fetal abdominal circumference and fetal head orientation, and the amount of bleeding at 2 and 24 hours postpartum was significantly different between the two groups.There was significant difference in postpartum hospitalization time (P 0.05), but there was no significant difference in uterine rupture rate between the two groups (P 0.05), but there was no significant difference in asphyxia rate, neonatal Apgar score and hospitalization rate between the two groups.Conclusion the pregnant women who are pregnant again after cesarean section can be evaluated whether they can deliver through vagina before delivery. If the pregnant woman does not have the indication of cesarean section, she can be guided to perform vaginal delivery after careful monitoring and multiple evaluations.In order to reduce the physical and mental health of mother and child, improve the quality of life of mother and child.
【作者单位】：福建医科大学附属闽东医院妇产科;
【分类号】：R714

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