不同的分娩方式对再次妊娠的瘢痕子宫患者分娩结局的影响

发布时间：2018-05-30 23:04

本文选题：瘢痕子宫 + 再次妊娠　；参考：《当代医药论丛》2016年22期

【摘要】：目的 :探讨不同的分娩方式对再次妊娠的瘢痕子宫患者分娩结局的影响。方法 :选取2014年1月~2016年5月期间我院妇产科收治的76例再次妊娠的剖宫产所致瘢痕子宫孕产妇作为研究对象。根据孕产妇的实际情况及个人意愿将这76例孕产妇分为阴道试产组(n=38例)与剖宫产组(n=38例),分别对其进行阴道试产与剖宫产手术。然后,比较两组孕产妇产后的出血量、产后并发症的发生情况、住院的时间及新生儿Apgar评分、新生儿的窒息率、新生儿的体质量。结果 :在38例阴道试产组孕产妇中,有31例孕产妇成功地顺产,其顺产率为81.57%,有8例孕产妇中转剖宫产,其中转剖宫产率为21.05%,其产后未发生产褥感染、子宫内膜炎等并发症。本组孕产妇产后的平均出血量为(135.6±18.7)ml,平均住院的时间为(2.7±1.9)d。在38例剖宫产组孕产妇中,有2例孕产妇发生了产褥感染,有1例孕产妇发生了子宫内膜炎,其产后并发症的发生率为7.89%。本组孕产妇产后的平均出血量为(264.2±22.8)ml,平均住院的时间为(3.9±2.1)d。阴道试产组孕产妇产后的平均出血量、平均住院的时间、产后并发症的发生率均明显低于剖宫产组孕产妇,差异有统计学意义(P0.05)。阴道试产组新生儿的Apgar评分明显高于剖宫产组,其新生儿窒息率明显低于剖宫产组,差异有统计学意义(P0.05)。结论 :对于再次妊娠的剖宫产所致瘢痕子宫的孕产妇,在严格把握其适应症和禁忌症的前提下,进行阴道试产可以降低其剖宫产率,减少其产后并发症的发生率,保障母婴的安全与健康。
[Abstract]:Objective: to investigate the effect of different delivery modes on the delivery outcome of scar uterus patients with re-pregnancy. Methods: from January 2014 to May 2016, 76 cases of cicatricial uterus caused by cesarean section in our hospital from January 2014 to May 2016 were selected as the research objects. According to the actual situation and personal wishes of the pregnant and parturient, the 76 pregnant and parturient women were divided into the vaginal trial delivery group (n = 38) and the cesarean section group (n = 38). The vaginal trial delivery and the cesarean section were performed respectively. Then, the amount of postpartum bleeding, the occurrence of postpartum complications, the time of hospitalization, the Apgar score of newborn, the asphyxia rate of newborn and the weight of newborn were compared between the two groups. Results: among 38 cases of vaginal trial delivery, 31 cases were successfully delivered smoothly, the rate of spontaneous delivery was 81.57, and 8 cases were converted to cesarean section, the rate of transition to cesarean section was 21.05%. There was no puerperal infection, endometritis and other complications after delivery. The average amount of postpartum bleeding was 135.6 卤18.7 ml, and the average hospitalization time was 2.7 卤1.9 days. In 38 cases of cesarean section, 2 cases had puerperal infection and 1 case had endometritis. The incidence of postpartum complications was 7.89%. The average amount of postpartum bleeding was 264.2 卤22.8ml, and the average hospitalization time was 3.9 卤2.1 days. The average amount of postpartum bleeding, the average length of hospitalization and the incidence of postpartum complications in the vaginal trial delivery group were significantly lower than those in the cesarean section group, and the difference was statistically significant (P 0.05). The Apgar score in vaginal trial delivery group was significantly higher than that in caesarean section group, and the neonatal asphyxia rate was significantly lower than that in caesarean section group (P 0.05). Conclusion: for pregnant women with scar uterus caused by cesarean section, vaginal trial delivery can reduce the rate of cesarean section and the incidence of postpartum complications under strict control of indications and contraindications. To ensure the safety and health of mother and child.
【作者单位】：锦江区妇幼保健院;
【分类号】：R714.4

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