摘要
目的 探讨40岁及以上剖宫产术后瘢痕子宫再次妊娠的孕妇经阴道分娩的安全性。方法 回顾性分析2020年1月至2022年10月厦门大学附属妇女儿童医院产科收治的40岁及以上剖宫产术后再次妊娠的孕妇90例,根据分娩方式分为阴道分娩组30例和再次剖宫产组60例,将同期非高龄(<35岁)瘢痕子宫再次妊娠经阴道分娩的60例孕妇作为对照组,比较各组的分娩结局。结果 与再次剖宫产组比较,40岁及以上阴道分娩组24 h产后出血量、产后并发症发生率、住院时间、新生儿重症监护室入住率明显减少,差异有统计学意义(P <0.05),新生儿出生体重、新生儿阿氏评分比较差异无统计学意义(P> 0.05);与对照组比较,40岁及以上阴道分娩组24h产后出血量、会阴侧切率、住院时间、新生儿阿氏评分、重症监护室入住率、新生儿出生体重差异均无统计学意义(P> 0.05),但产程时间明显较长,差异有统计学意义(P <0.05)。结论瘢痕子宫再次妊娠的≥40岁以上孕妇经阴道分娩是安全可行的。
Objective To investigate the safety of vaginal delivery in pregnant women≥40 years of age with scarred uterus after cesarean section.Methods A total of 90 pregnant women≥40 years of age after cesarean section who were admitted to the Department of Obstetrics in Women and Children’s Hospital Affiliated to Xiamen University from January 2020 to October 2022 were retrospectively analyzed.They were divided into a vaginal delivery group(n=30)and a repeat cesarean delivery group(n=60)according to the delivery methods,and another 60 non-senior pregnant women(<35 years of age)with scarred uterus who delivered vaginally in the same period were selected as the control group.The delivery outcomes were compared among the three groups.Results The 24h postpartum hemorrhage,the incidence of postpartum complications,hospital stay,and the rate ofadmission to the neonatal intensive care unit in the vaginal delivery group were significantly less/shorter/lower than those in the repeat cesarean delivery group,with statistically significant differences(P<0.05),while there were no statistically significant differences between the two groups in the neonatal birth weight and neonatal Apgar score(P>0.05).There were no statistically significant differences between the control group and the vaginal delivery group in 24h postpartum hemorrhage,lateral episiotomy rate,hospital stay,neonatal Apgar score,neonatal intensive care unit admission rate,and neonatal birth weight(P>0.05),while the length of labor in the vaginal delivery group was significantly longer than that in the control group(P<0.05).Conclusion Vaginal delivery is safe and feasible for pregnant women≥40 years of age with scarred uterus.
作者
冷芹
于威威
张雪芹
LENG Qin;YU Weiwei;ZHANG Xueqin(Department of Obstetrics,Women and Children’s Hospital Affiliated to Xiamen University,Xiamen Maternity and Child Health Care Hospital,Fujian,Xiamen 361000,China)
出处
《中国医药科学》
2023年第5期134-137,共4页
China Medicine And Pharmacy
关键词
瘢痕子宫
高龄产妇
剖宫产术后再次妊娠阴道分娩
妊娠结局
Scarred uterus
Elderly pregnant women
Vaginal delivery for second pregnancy after cesarean section
Pregnancy outcome
