分析剖宫产术后瘢痕子宫妊娠分娩方式及结局.docVIP

分析剖宫产术后瘢痕子宫妊娠分娩方式及结局 　　[摘要] 目的 为了深入研究剖宫产术后瘢痕子宫妊娠产妇的分娩方式，并探讨不同分娩方式对胎儿的影响。 方法 选取2013年7月―2014年7月在该院进行生产的瘢痕子宫妊娠患者90例，将其随机分成A组与B组，每组45例，A组中的产妇进行阴道试产，B组中的产妇进行再次剖宫产，对比两组产妇的分娩情况。 结果 A组的分娩成功率为88.9%低于B组100%的成功率；但是A组产后并发率为8.9%，低于B组22.2%的产后并发率，差异有统计学意义（P0.05）；A组有4例发生并发症，并发率为8.9%，B组中有10例发生并发症，并发率为22.2%，差异有统计学意义（P0.05）。 结论 两种不同的分娩方式对剖宫产术后瘢痕子宫妊娠的产妇的分娩的结局无影响，但是A组并发症发生几率小。 　　[关键词] 瘢痕子宫；妊娠；剖宫产；分娩方式；结局 　　[中图分类号] R71 [文献标识码] A [文章编号] 1674-0742（2016）05（a）-0037-03 　　[Abstract] Objective To deeply research the delivery method of pregnant women with uterine scar pregnancy after cesarean section and discuss the effect of different delivery methods on fetuses. Methods 90 cases of patients with uterine scar pregnancy giving birth in our hospital from July 2013 to July 2014 were selected and randomly divided into two groups with 45 cases in each， the group A adopted trial of labor， the group B adopted repeat cesarean section， and the delivery conditions of the two groups were compared. Results The delivery success rate in the group A was lower than that in the group B （88.9% vs 100%）， but the postpartum complication rate in the group A was lower than that in the group B （8.9% vs 22.2%）， and the difference had statistical significance（P0.05）， in the group A， complications occurred to 4 cases and the complication rate was 8.9%， in the group B， complications occurred to 10 cases， and the complication rate was 22.2%， and the difference had statistical significance（P0.05）. Conclusion Two different delivery methods have no effect on the pregnant women with uterine scar pregnancy after cesarean section， but the occurrence probability of complications in the group A was small. 　　[Key words] Uterine scar； Pregnancy； Cesarean section； Delivery method； Outcome 　　瘢痕子宫指的是剖宫产手术或者肌壁间肌瘤剥除术后的子宫，瘢痕子宫对产妇再次妊娠的孕期。分娩及产后具有较大影响[1]。瘢痕子宫再次妊娠很有可能引发胎盘前置、产后出血、子宫破裂出血等不良情况的发生。另外，瘢痕子宫产妇妊娠待分娩时，剖宫产会对切口造成愈合不良、感染、粘连严重、损伤等并发症。剖宫产是产科中最重要的手术，随着麻醉技术的逐渐提升，剖宫产的认可度明显上升[2]，瘢痕子宫再次妊娠引发很大关注[3]。为了提高剖宫产术后瘢痕子宫妊娠分娩的成功率，该文对2013年7月―2014年7