摘要
目的:探讨影响剖宫产瘢痕子宫再次妊娠阴道试产结局的相关因素。方法:回顾性分析218例剖宫产术后瘢痕子宫再次妊娠阴道试产产妇临床资料,根据阴道试产结局分为失败组(n=32)和成功组(n=186)。通过logistic回归模型分析影响剖宫产瘢痕子宫再次妊娠阴道试产结局的相关因素。结果:218例阴道试产成功186例(85.3%)。多因素logistic回归分析显示:年龄≥35岁(OR=2.371,95%CI 1.401~4.383)、产前BMI≥30kg/m^(2)(OR=4.805,95%CI 2.636~7.209)、子宫下段肌层厚度<4mm(OR=3.636,95%CI 1.472~5.810)、距离上次分娩时间<3年(OR=1.827,95%CI 1.186~3.461)、新生儿体重≥3.5kg(OR=2.850,95%CI 1.295~5.116)、羊水污染(OR=2.613,95%CI 1.053~4.875)是剖宫产瘢痕子宫再次妊娠阴道试产失败的影响因素(P<0.05)。结论:高龄、产前肥胖、子宫下段肌层厚度不足、分娩间隔时间短、婴儿体质量过大、羊水污染对剖宫产瘢痕子宫再妊娠阴道试产结局产生不利影响。
Objective:To explore the relevant factor of the outcomes of the vaginal trial delivery of subsguent pregnancy of women with scar uterus after cesarean section.Methods:The clinical data of 218 pregnant women with scar uterus after cesarean section who had tried vaginal delivery were analyzed retrospectively.These women were divided into group A(32 women with failure vaginal delivery)and group B(186 women with successful vaginal delivery)according to the outcomes of trial vaginal delivery.Logistic regression model analysis was used to analyze the influencing factors of the vaginal trial delivery outcomes of the second pregnancy of women with scar uterus after cesarean section.Results:There were 186(85.3%)women with successful vaginal trial delivery in the total 218 women.Multivariate logistic regression analysis showed that,the age≥35 years old(OR=2.371,95%CI1.401-4.383),the prenatal body mass index(BMI)≥30 kg/m^(2)(OR=4.805,95%CI 2.636-7.209),the lower uterine segment muscle layer thickness<4 mm(OR=3.636,95%CI 1.472-5.810),the time from the last delivery<3 years(OR=1.827,95%CI 1.186-3.461),the neonatal weight≥3.5 kg(OR=2.850,95%CI 1.295-5.116),and the amniotic fluid pollution(OR=2.613,95%CI 1.053-4.875)were the influence factors of vaginal trial delivery failure of the second pregnancy of women with scar uterus after cesarean section(P<0.05).Conclusion:Advanced age,prenatal obesity,insufficient lower uterine muscle thickness,short delivery interval,excessive infant BMI,and amniotic fluid pollution of the women with scar uterus after cesarean section have adverse influence on their vaginal trial delivery outcomes of the second pregnancy.
作者
杨阿敏
邹仙玲
周维敏
YANG Amin;ZOU Xianling;ZHOU Weimin(Hangzhou Obstetrics and Gynecology Hospital,Hangzhou Maternal and Child Health Care Hospital of Zhejiang Province,Hangzhou,Zhejiang Province,310007)
出处
《中国计划生育学杂志》
2023年第1期140-143,共4页
Chinese Journal of Family Planning
关键词
剖宫产
瘢痕子宫
再次妊娠
阴道分娩
Cesarean section
Scarred uterus
Subsguent pregnancy
Vaginal delivery
