摘要
目的探讨剖宫产术后再次妊娠分娩方式的选择与肥胖产妇自身因素的相关性。方法选取深圳市宝安区福永人民医院2015年12月-2016年11月收治的530例剖宫产术后再次妊娠的肥胖产妇资料进行回顾性分析,根据不同分娩方式分为剖宫产组与经阴道分娩组,分析对比选择两种不同分娩方式的肥胖产妇自身因素差异及分娩过程差异,汇总其影响因素为剖宫产术后再次妊娠分娩方式的选择提供依据。结果两组再次妊娠的肥胖产妇术前影响因素分析中,剖宫产组再次妊娠的肥胖产妇在上次分娩子宫切口愈合不良、具有重度子痫前期、经皮血氧饱和度低、胎盘附着位置异常与经阴道分娩组相比差异有统计学意义(P<0.05)。两组再次妊娠的肥胖产妇术中影响因素分析中,剖宫产组再次妊娠的肥胖产妇在术中出血量、最低平均动脉压、是否为急诊分娩与经阴道分娩组相比差异有统计学意义(P<0.05)。两组再次妊娠的肥胖产妇术后影响因素分析中,剖宫产组再次妊娠的肥胖产妇在机械通气时间、低氧血症、急性肾功能衰竭与经阴道分娩组相比差异有统计学意义(P<0.05)。再次妊娠的肥胖产妇初步筛选的影响因素应用回归分析结果可知,术前胎盘附着位置异常、子宫切口愈合不良、重度子痫前期是影响再次妊娠肥胖产妇发生术后谵妄的独立影响因素(P<0.05)。结论剖宫产术后再次妊娠的肥胖产妇进行不同术式的自身因素对比分析提示术前胎盘附着位置异常、子宫切口愈合不良、重度子痫前期为独立危险因素,应高度注意具有影响因素的产妇采取剖宫产术式,对于不具备高危因素的产妇可进行经阴道分娩。
Objective To explore the correlation between the choice of delivery modes and the related factors of obese delivery women after cesarean section.Methods The data of 530 obese delivery women after cesarean section treated in the hospital from December 2015 to November 2016 was analyzed retrospectively.All the delivery women were divided into cesarean section group and transvaginal delivery group.The differences of related factors of obese delivery women and delivery process were analyzed and compared between the two groups.The influencing factors were summarized to provide a basis for choice of delivery modes after cesarean section.Results Among the preoperative influencing factors,there were statistically significant differences in the rates of poor healing of uterus incision,severe preeclampsia,low transcutaneous oxygen saturation,and abnormal placental position between the two groups （P〈0.05）.Among the intraoperative influencing factors,there were statistically significant differences in the amount of intraoperative blood loss,the lowest mean arterial pressure,emergency delivery or not between the two groups （P〈0.05）.Among the postoperative influencing factors,there were statistically significant differences in mechanical ventilation time,hypoxemia,and acute renal failure between the two groups （P〈0.05）.Regression analysis showed that preoperative abnormal placental position,poor healing of uterus incision,and severe preeclampsia were independent risk factors of postoperative delirium among the obese delivery women after cesarean section （P〈0.05）.Conclusion Preoperative abnormal placental position,poor healing of uterus incision,and severe preeclampsia were independent risk factors,the delivery women with influencing factors should adopt cesarean section,and the delivery women without high-risk factors can adopt transvaginal delivery.
出处
《中国妇幼保健》
CAS
2017年第17期4090-4092,共3页
Maternal and Child Health Care of China
关键词
剖宫产
再次妊娠
肥胖产妇
妊娠分娩方式
Cesarean section
Subsequent pregnancy
Obese delivery woman
Delivery mode
