剖宫产后瘢痕子宫再次妊娠分娩方式临床观察.docVIP

剖宫产后瘢痕子宫再次妊娠分娩方式临床观察 　　【摘要】 目的 探讨剖宫产后瘢痕子宫再次妊娠分娩的方式及其临床效果。方法 142例剖宫产后瘢痕子宫再次妊娠分娩产妇， 随机分为观察A组20例（经瘢痕子宫再次妊娠阴道分娩产妇）、观察B组122例（瘢痕子宫再次妊娠剖宫产分娩产妇）， 对照组142例（同期非瘢痕子宫阴道分娩产妇）， 对比观察A组与观察B组、观察A组与对照组的分娩结局。结果 观察A组产妇产后24 h平均出血量[（301.55±9.85）ml]、平均住院天数[（6.41±1.10）d]、产褥率[5.00%（1/20）]以及新生儿窒息率[5.00%（1/20）]均显著低于观察B组， 比较差异具有统计学意义（P0.05）。结论 在分娩过程中进行严密的监视并掌控好经阴道分娩指征的前提下， 对剖宫产瘢痕子宫再次妊娠分娩的产妇选择经阴道分娩比其他分娩方式更为安全。 　　【关键词】 剖宫产；瘢痕子宫；再次妊娠；分娩方式 　　【Abstract】 Objective To investigate the clinical effect of scarred uterus re-pregnancy and its delivery mode after cesarean section. Methods A total of 142 puerpera with scarred uterus re-pregnancy after cesarean section were randomly divided into observation A group with 20 cases （puerpera with scarred uterus re-pregnancy by vaginal delivery after cesarean section） and observation B group with 122 cases （puerpera with scarred uterus re-pregnancy by cesarean section again）. There were 142 cases in control group （puerpera without scarred uterus by vaginal delivery at the same period）. Comparisons of delivery outcomes were made between observation A group and observation B group， and between observation A group and control group. Results The observation A group had much lower postpartum 24 h bleeding volume as [（301.55±9.85）ml]， average hospital stay as [（6.41±1.10）d]， childbed rate as [5.00% （1/20）]， and neonatal asphyxia rate as [5.00% （1/20）] than the observation B group. Their difference had statistical significance （P0.05）. Conclusion On the basis of closely monitoring and good control of vaginal delivery indications， choice of vaginal delivery for puerpera with scarred uterus re-pregnancy after cesarean section is safer than other delivery modes. 　　【Key words】 Cesarean section； Scarred uterus； Re-pregnancy； Delivery mode 　　临床分娩过程中产妇因子宫肌瘤剔除术以及剖宫产术或者子宫穿孔修补术等原因而在子宫留下瘢痕， 都称之为瘢痕子宫。在我国受孕妇、社会因素以及医务人员等因素的影响， 越来越多的产妇在分娩的时候会选择剖宫产， 麻醉技术水平的提高和剖宫技术的水平不断更新在一定程度上也给剖宫产手术的安全性提供良好的保证， 我国部分地区剖宫产手术应用率已经达到80%， 随着瘢痕子宫再次妊娠的不断增加， 分娩过程中一旦未采用合理的分娩方式， 产妇甚至会出现子宫破裂、大出血、新生儿窒息以及子宫切