摘要
目的:探讨瘢痕子宫阴道分娩的可行性及安全性。方法:选取2016年1月—2017年12月本院收治的剖宫产术后再次妊娠具有试产条件的产妇160例,分为阴道试产成功和试产失败组,观察产妇产后出血、产褥感染、新生儿窒息等情况。结果:阴道试产成功率为76.3%;试产成功组子宫瘢痕厚度、距上次剖宫产时间明显大于和长于试产失败组,而产前BMI明显低于试产失败组,差异均有统计学意义(P<0.05);试产成功组产后24h内阴道出血量明显少于试产失败组,差异有统计学意义(P<0.05);两组产褥感染、新生儿体重和5min Apgar评分比较差异无统计学意义(P>0.05);logistic回归分析显示产前BMI(>30kg/m^2)和距上次剖宫产时间(≤2年)是瘢痕子宫阴道分娩的影响因素。结论:瘢痕子宫阴道分娩具有可行性,不会增加新生儿窒息的风险,但产后出血量偏多。
Objective: To investigate the feasibility and safety of vaginal delivery of women with history scar uterus. Methods: From January 2016 to December 2017, 160 pregnant women with history cesarean were selected and divided into group A(the success of vaginal delivery group) and group B(the failure of vaginal delivery group). The incidences of postpartum hemorrhage, puerperal infection, and neonatal asphyxia of women in both groups were observed. Results: The successful rate of vagina delivery was 76.3%. The thickness of scar or the time from the last cesarean section of women in group A were significantly thicker or longer than that of women in group B, but the prenatal BMI of women in group A was significant lower than that of women in group B(P<0.05). The amount of vaginal bleeding in postpartum 24 h of women in group A was significant less than that of women in group B(P<0.05). There were no significant different in rate of puerperal infection, fetal body mass, and postnatal 5 min Apgar score of newborns between the two groups(P>0.05). Logistic regression analysis showed that prenatal BMI(> 30 kg/m^2) and the time from the last cesarean section(≤2 years) were the influencing factors of vaginal delivery successfully. Conclusion: The vaginal delivery of pregnant women with history scar uterus is feasible without increase the risk of neonatal asphyxia, but the amount of postpartum hemorrhage maybe increase.
作者
张莹
Zhang Yin(The First People's Hospital of Huainan City,Anhui Province,232007)
出处
《中国计划生育学杂志》
2019年第2期199-201,共3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
Scar uterus
Pregnancy again
Vaginal delivery
