摘要
目的探讨剖宫产术后再次妊娠分娩方式的选择。方法选取2016年12月—2019年9月在北京新世纪妇儿医院进行剖宫产术后阴道试产(trial of labor after cesarean section,TOLAC)并成功阴道分娩的产妇45例做为研究组,随机配对选择同期进行选择性再次剖宫产(elective repeat cesarean section,ERCS)的产妇47例为对照组。对两组产妇的孕期情况及产后母儿情况进行分析比较,分析对照组内前次和本次剖宫产指征为社会因素所占比例。结果研究组和对照组的年龄、教育程度、有无阴道分娩史、距离前次剖宫产时间、子宫下段厚度、产前BMI、新生儿体质量、产后24 h出血量差异无统计学意义(P> 0.05)。两组均未出现新生儿窒息。研究组住院时间少于对照组,差异具有统计学意义(P <0.05)。对照组前次剖宫产指征为社会因素者22例,占该组总人数的46.81%;本次剖宫产指征为社会因素者43例,占该组总人数的91.49%,差异具有统计学意义(P <0.05)。结论在严格掌控TOLAC的适应症和严密监护试产全程的前提下,TOLAC具备可行性和安全性。前次剖宫产指征为社会因素者,再次妊娠行二次剖宫产的可能性更大。
Objective To explore the choice of delivery mode of the second pregnancy after cesarean section. Methods To select 45 women who had TOLAC(trial of labor after cesarean section) and delivered successfully in Beijing New Century Women’s and Children’s Hospital from December 2016 to September 2019 as the study group, and to select 47 women randomly who had ERCS(elective repeat cesarean section) during the same period as control group. To compare and analyze the pregnancy and postpartum maternal and neonatal condition of the two groups. To analyze the proportion of women whose cesarean section indications are social factors between the first operation and the second operation in the control group. Results There were no significant differences in the age, education level, vaginal delivery history, the time from the previous cesarean section, lower uterine thickness, antepartum BMI, neonatal weight, and the amount of postpartum bleeding in 24 hours between the study group and the control group(P > 0.05). There was no asphyxia neonatorum in both groups. The length of hospital stay in the study group was significantly less than that in the control group(P < 0.05). In the control group, there were 22 cases that the previous cesarean section indications are social factors, which account for 46.81% of the group’s total population;there were 43 cases that the second cesarean section indicators are social factors, which account for 91.49% of the group’s total population. The difference was statistically significant(P < 0.05). Conclusion Under the premise of strictly controlling the indications of TOLAC and closely monitoring the whole process of vaginal trial, TOLAC is considered to be feasible and safe. Those whose previous cesarean section indications were social factors are more likely to have a second cesarean section during their second pregnancy.
作者
唐宏
TANG Hong(Obstetric Department,Beijing New Century Women’s and Children’s Hospital,Beijing 100102,China)
出处
《中国卫生标准管理》
2021年第14期96-98,共3页
China Health Standard Management
关键词
剖宫产
瘢痕子宫
妊娠
阴道试产
分娩
社会因素
cesarean section
scared uterus
pregnancy
vaginal trial
delivery
social factor
