剖宫产术后再次妊娠分娩方法学探究.docVIP

剖宫产术后再次妊娠分娩方法学探究【摘要】 目的 探讨剖宫产术后再次妊娠的分娩方式。方法 对我院432例剖宫产术后再次妊娠孕妇的分娩方式、结局及母婴并发症进行回顾性分析。并将其中再次剖宫产(RCS)292例与随机抽取同期首次剖宫产(PCS)292例进行对照，将其中剖宫产术后阴道分娩(VBAC)140例与随机抽取同期非瘢痕子宫阴道分娩(VBNC)140例进行对照。结果 VBAC组新生儿窒息、产后出血量、先兆子宫破裂发生率与对照组比较，差异无统计学意义。RCS组较VBAC组产后出血量高，平均住院天数多，经济费用高。RCS组产后出血率较PCS组高，差异有统计学意义。结论 剖宫产并非是剖宫产术后再次妊娠分娩的绝对指征，符合试产条件者在严密监护下阴道试产是安全可行的。? 【关键词】 剖宫产；再次妊娠；分娩方式;阴道试产 The study of the repeated pregnanuy after cescerean section delivery mode YANG Xue?ying.Department of Gynaecology and obstetrics,The Fouth Peoples Hospital of Jinan,Jinan 250031,China ? 【Abstract】 Objective To investigate the repeated pregnancy after cesarean section delivery mode. Methods 432 cases of cesarean section after pregnancy outcome and mode of delivery, maternal complications were retrospectively analyzed. And the second cesarean section (RCS) of 292 cases with randomly selected from a first cesarean section (PCS) in 292 cases were controlled, the vaginal birth after cesarean section (VBAC) of 140 cases with randomly selected over the same period of scar womb vaginal delivery (VBNC) in 140 cases. Results The VBAC group, postpartum hemorrhage, neonatal asphyxia of threatened uterine rupture occurred rate compared with the control group, no significant difference. RCS group than in VBAC group of postpartum blood loss was high, the average length of hospital stay, cost was high. RCS group of postpartum hemorrhage rates higher than those of PCS group, there were significant differences. Conclusion Cesarean section is not repeated pregnancy after cesarean section delivery of the absolute indications, with trial production conditions in the intensive care of vaginal delivery is safe and feasible.? 【Key words】 Delivery mode;Vaginal trial?produce ? 随着剖宫产技术的提高及术式的不断完善，在现代产科临床上剖宫产已成为解决难产和某些产科合并症、抢救孕产妇和围生儿生命的有效手段。近年来，由于种种原因，剖宫产率异常上升，已经引起社会的广泛关注［1］。剖宫产术后再次妊娠分娩已成为临床上突出的问题。本文对我院剖宫产术后再次妊娠432例临床资料进行回顾性分析，以探讨剖宫产术后再次妊娠分娩方式的选择。? 1 资料与方法? 1.1 一般资料 我院2006年5月至2011年10月剖宫产术后再次妊娠分娩者432例，占同