摘要
目的:调查剖宫产后再次妊娠的分娩方式并分析影响因素。方法:回顾性收集2016年1月-2022年6月于本院产科住院分娩的剖宫产术后再次妊娠孕妇496例的临床资料,根据分娩方式分为经阴道分娩组和剖宫产组,比较两组临床指标并分析对分娩方式的影响。结果:496例尝试经阴道分娩141例(28.4%),最终经阴道分娩成功114例,成功率80.9%,27例转行剖宫产,合计经剖宫产分娩382例(77.0%)。多因素logistic回归分析显示,孕妇初始经阴道分娩意愿、自然分娩史、入院宫口扩张>3cm均是经阴道分娩的有利因素,产前高体质指数(>30kg/m^(2))、妊娠合并症、胎位及胎心异常均是经阴道分娩的不利因素(均P<0.05);经阴道分娩组新生儿1min Apgar评分(9.3±0.3分)高于剖宫产组(9.0±0.3分)(P<0.05),分娩结局、新生儿出生体重、新生儿窒息等比较均无差异(P>0.05),结论:本次调查剖宫产孕妇再次妊娠分娩以剖宫产为主,入院宫口扩张程度、自然分娩史、初始分娩意愿、产前体质指数、妊娠合并症、胎心及胎位情况均是影响经阴道分娩的影响因素,临床产科应根据孕妇具体情况选择合理的分娩方式。
Objective: To investigate the mode of delivery mode of pregnant women after previous cesarean section, and to analyze the influencing factors of the delivery mode. Methods: The clinical data of 496 women with pregnancy again after cesarean section from January 2016 to June 2022 were collected retrospectively. These pregnant women were divided into group A(women terminated pregnancy by vaginal delivery) and group B(women terminated pregnancy by cesarean section again) according to the delivery mode. The clinical indicators of the women were compared between the two groups, and the influence of the clinical indicators on their delivery mode was analyzed. Results: Among 496 pregnant women, 141(28.4%) cases tried to vaginal delivery, and 114 cases had successful vaginal delivery, with the success rate of 80.9%, and the left 27 women converted to cesarean section. There were 382(77.0%) cases delivered by cesarean section. Multiple logistic regression analysis showed that the initial intention of vaginal delivery, the history of natural delivery, and the uterine orifice opening >3cm when admission of hospital of the women were the favorable factors of their vaginal delivery, while the high prenatal body mass index(>30kg/m^(2)), the pregnancy complications, the fetal position, and the fetal heart abnormalities of the women were the unfavorable factors of their vaginal delivery(all P<0.05). The 1 min Apgar score(9.3±0.3 points) of the newborn after vaginal delivery was significantly higher than that(9.0±0.3 points) of the newborn after cesarean section(P<0.05). There were no significant differences in the delivery outcomes, the birth weight of newborns, and the neonatal asphyxia rate between the women after vaginal delivery and the women after cesarean section(P>0.05). Conclusion: In this survey, the caesarean section is the main delivery mode of the pregnant women after previous cesarean section. The degree of uterine orifice opening when admission of hospital, the history of natural delivery, the initial intention of
作者
张凡
郭睿
辛德梅
ZHANG Fan;GUO Rui;XIN Demei(Beijing Weeping Willow Hospital,Beijing,10002)
出处
《中国计划生育学杂志》
2023年第2期246-250,共5页
Chinese Journal of Family Planning
关键词
剖宫产后再次妊娠
分娩方式
影响因素
The second pregnancy after cesarean section
Delivery mode
Influencing factor
