摘要
目的探讨剖宫产术后再次妊娠阴道分娩孕妇采用COOK球囊联合催产素引产的安全性及可行性。方法回顾性分析2021年7月至2022年7月成都市龙泉驿区第一人民医院收治的剖宫产术后再次妊娠符合阴道试产条件并知情同意阴道试产的孕妇60例(瘢痕子宫组)及同期有引产指征的初产妇100例(初产妇组)和经产妇100例(经产妇组)采用COOK球囊联合催产素引产的病例资料,分析3组产妇促宫颈成熟前后宫颈评分、总产程、阴道分娩率、阴道助产率、产后出血量、产道损伤、新生儿结局等情况。结果3组孕妇COOK球囊促宫颈成熟前后宫颈评分、产后出血量及新生儿1 min Apgar评分比较,差异无统计学意义(P>0.05);瘢痕子宫组与初产妇组阴道分娩率差异无统计学意义,经产妇组阴道分娩率最高;经产妇组在3组中总产程短、产道损伤少,新生儿窒息率低、新生儿产伤少(P<0.05);其次为瘢痕子宫组,初产妇组在3组中总产程最长,新生儿及产妇损伤相对较前两组多。结论COOK球囊联合催产素引产在剖宫产术后再次妊娠阴道分娩孕妇的引产与非瘢痕子宫相比同样安全有效,且不增加相关并发症。
Objective To explore the safety and feasibility of using COOK balloon with oxytocin induction in second parous women who had a vaginal birth after cesarean.Methods A retrospective analysis of the clinical data of 60 pregnant women after cesarean section and met the conditions of vaginal trial and informed consent to vaginal trial(scar uterus group)and 100 primipara(primipara group)and 100 multipara(multipara group)with indications of induced labor in the same period who were admitted to the First People's Hospital of Longquanyi District,Chengdu from July 2021 to July 2022.All pregnant women were induced labor with COOK balloon and oxytocin.The cervical score before and after cervical ripening,total labor process,vaginal delivery rate,vaginal midwifery rate,postpartum hemorhage,birth canal injury,neonatal outcome and other conditions of the three groups were analyzed.Results There was no statistically significant difference in the cervical score,postpartum hemorrhage volume and the l-min Apgar score of the newborn between the three groups(P>0.05).There was no significant difference in the vaginal delivery rate between the scar uterus group and the primipara group.The vaginal delivery rate was the highest in the multiparous women group.In the multipara group,the total labor process was short,the birth canal injury,the neonatal asphyxia rate,and the neonatal birth injury was less;the second group was scar uterus group.The primipara group had the longest total labor process among the three groups,and the neonatal and maternal injuries were relatively more than the first two groups.Conclusion COOK balloon combined with oxytocin induction used for VBAC is as safe and effective as that used for non-cicatricial uterus,and does not increase complications.
作者
毛胜艳
周隽
郑钊平
林春霞
代庆凯
Mao Shengyan;Zhou Jun;Zheng Zhaoping;Lin Chunxia;Dai Qingkai(Department of Obstetrics,the First People's Hospital of Longquanyi District(Longquan Hospital,West China Hospital,Sichuan University),Chengdu Sichuan 610100;Key Laboratory of Birth Defects and Related Maternal and Child Diseases of the Ministry of Education,Laboratory,West China Second Hospital,Sichuan University,Chengdu Sichuan 610041,P.R.China)
出处
《中国计划生育和妇产科》
2023年第5期71-75,共5页
Chinese Journal of Family Planning & Gynecotokology
基金
成都市医学科研课题项目(项目编号:2022281)。
