摘要
目的动态观察宫颈Bishop评分在预测剖宫产术后再次妊娠阴道分娩(VBAC)中子宫破裂的价值。方法对2013年6月至2014年3月禄丰县人民医院70例VBAC(研究组)的分娩结局及母婴并发症进行回顾性分析,并和同期首次阴道分娩70例患者进行对照。结果研究组55例阴道试产成功,成功率78.5%;对照组63例阴道试产成功,成功率90.0%,两组阴道分娩率无统计学差异(x^2=3.45,P=0.06)。研究组因宫颈条件不良行剖宫产率(17.1%)显著高于对照组(0.04%)x^2=11.43,P<0.05。研究组4例新生儿轻度窒息,对照组6例新生儿轻度窒息,两组无显著性差异(x^2=0.43,P=0.05),两组产后出血量比较无显著性差异(t=0.67,P=0.30)。结论剖宫产术后再次妊娠符合阴道分娩条件者在严密监护下阴道分娩是安全的,但阴道试产4小时后宫颈Bishop评分变化≤2分,建议及时终止妊娠,预防子宫破裂。
Objective To assess the value of dynamic cervical Bishop score observation in predicting uterine rupture in vaginal birth after cesarean section （ VBAC） .Methods A retrospective study was conducted on delivery outcomes and maternal and neonatal complications of 70 cases in VBAC group during the period of June 2013 to March 2014.At the same period 70 controls with first vaginal birth were compared in Lufeng People’ s Hospital.Results There was no significant difference in the successful rate of vaginal delivery between VBAC group （55, 78.5%） and the control group （63, 90.0%） （χ2 =3.45,P=0.06）.Because of poor cervical conditions, the cesarean section rate in VBAC group （17.1%） was significantly higher than that in the control group （0.04%） （χ2 =11.43,P〈0.05）.There were 4 and 6 newborns with mild choking in VBAC group and the control group, respectively, but the difference was not significant （χ2 =0.43,P=0.05）.There was no significant difference in the amount of postpartum bleeding between two groups （t=0.67,P=0.30）. Conclusion VBAC is safe under close observation when it is conformed to vaginal trial production.But if cervical Bishop score≤2 after 4 hours of vaginal trial production, timely termination of pregnancy is recommended to prevent uterine rupture.
出处
《中国妇幼健康研究》
2014年第5期797-798,810,共3页
Chinese Journal of Woman and Child Health Research
