摘要
目的分析瘢痕子宫再次妊娠孕妇终止妊娠的方式选择。方法回顾性分析2019年1月至2021年12月南阳市中心医院收治的96例晚期妊娠瘢痕子宫孕妇的临床资料,结合不同终止妊娠方式分成对照组(在适宜时机采取剖宫产终止妊娠)50例和观察组(在适宜时机采取阴道分娩终止妊娠)46例。比较两组产时及产后2 h出血量、住院时间和住院费用;母婴并发症;新生儿体质量及Apgar得分;分娩前后血清皮质醇(Cor)、去甲肾上腺素(NE)及血管紧张素Ⅱ(ATⅡ)水平。结果观察组的产时及产后2 h出血量少于对照组,差异有统计学意义(P<0.05),住院时间短于对照组,差异有统计学意义(P<0.05),住院费用少于对照组,差异有统计学意义(P<0.05)。观察组的产褥感染、子宫出血、子宫破裂、新生儿黄疸、新生儿湿肺以及新生儿窒息等并发症发生率低于对照组,差异有统计学意义(P<0.05)。两组的新生儿体重及Apgar得分相比,差异无统计学意义(P>0.05)。分娩后,两组的Cor、NE、ATII水平均较前升高,差异有统计学意义(P<0.05),观察组的Cor、NE、ATII水平低于对照组,差异有统计学意义(P<0.05)。结论瘢痕子宫再次妊娠孕妇,于晚孕期仔细评估其阴道分娩可能性,并严密监测母婴状态,在具备输血和抢救等条件下,能采取阴道分娩以终止妊娠,可降低产后出血量,缩短住院时间,减少住院费用及母婴并发症发生,缓解应激反应,改善新生儿预后。
Objective To analyze the choice of termination of pregnancy in the second pregnancy of cicatricial uterus.Methods Clinical data about 96 late-stage pregnancy women with scarred uterus admitted to our hospital from January 2019 to December 2021 were retrospectively analyzed.According to the different pregnancy termination modes,women were assigned to control group(N=50,properly terminate the pregnancy by cesarean section)and observation group(N=46,properly terminate the pregnancy by vaginal delivery).The pregnancy outcomes were appraised through the intrapartum and 2-hour postpartum bleeding volume,hospital stays,hospital expenses,maternal and neonatal complications,neonatal body weight,Apgar points,serum cortisol(Cor),norepinephrine(NE)and angiotensin-Ⅱ(ATII)levels.Results The intrapartum and 2-hour postpartum bleeding volume in the observation group were smaller than those in the control group,with statistically significant differences(P<0.05);The hospital stays in the observation group was shorter than control group,with statistically significant difference(P<0.05);The hospitalization costs in the observation group was lower than control group,with statistically significant difference(P<0.05);The incidences of complications like puerperal infection,uterine bleeding,uterine rupture,neonatal jaundice,wet lung and neonatal asphyxia in the observation group were lower than those in the control group,with statistically significant differences(P<0.05);The neonatal body weight and Apgar points between groups were not significantly different(P>0.05);After delivery,Cor,NE and ATII levels in two groups were significantly higher than before,with statistically significant differences(P<0.05);Cor,NE and ATII levels in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).Conclusion For pregnant woman with cicatricial uterus,in the late period of the second pregnancy,the possibility of having a vaginal delivery should carefully evaluated,the maternal and neonata
作者
李松丽
LI Songli(Department of Obstetrics,Nanyang Central Hospital,Nanyang Henan 473000,China)
出处
《临床研究》
2022年第11期26-30,共5页
Clinical Research
关键词
瘢痕子宫
再次妊娠
终止妊娠
剖宫产
阴道分娩
scarred uterus
repeated pregnancy
pregnancy termination
cesarean section
vaginal delivery
