瘢痕子宫再次妊娠经阴道分娩可行性及效果分析.docVIP

瘢痕子宫再次妊娠经阴道分娩可行性及效果分析 　　【摘要】 目的 探讨瘢痕子宫再次妊娠经阴道分娩的可行性及安全性。方法 60例瘢痕子宫再次妊娠经阴道分娩产妇设为实验组， 选择同期分娩的60例非瘢痕子宫再次妊娠经阴道分娩产妇设为对照组， 比较两组分娩情况、分娩结局及并发症情况。结果 实验组产妇分娩成功率91.7%低于对照组95.0%；两组产妇存活率均为100.0%， 差异均无统计学意义（P0.05）；实验组产程、产时出血量、新生儿Apgar评分与对照组相比， 差异均无统计学意义（P0.05）；实验组分娩并发症发生率38.3%高于对照组的18.3%（P0.05）。结论 瘢痕子宫再次妊娠经阴道分娩临床上可行性较强， 安全性较高， 能够减轻产妇痛苦， 降低术后并发症发生率， 值得推广应用。 　　【关键词】 瘢痕子宫；再次妊娠；经阴道分娩；可行性；安全性 　　DOI：10.14163/j.cnki.11-5547/r.2015.16.009 　　【Abstract】 Objective To investigate the feasibility and safety of scarred uterus re-pregnancy by vaginal delivery. Methods There were 60 puerpera with scarred uterus re-pregnancy by vaginal delivery as experimental group， and another 60 puerpera in the same period with non-scarred uterus re-pregnancy by vaginal delivery as control group. Delivery condition， outcomes and complications were analyzed in the two groups. Results The delivery success rate in the experimental group was 91.7%， which was lower than 95.0% in the control group. Both groups had puerperal survival rate as 100.0%， and their differences all had no statistical significance （P0.05）. The differences of stages of labor， intrapartum bleeding volume， and neonatal Apgar score between the two groups all had no statistical significance （P0.05）. The experimental group had higher incidence of delivery complications as 38.3% than 18.3% of the control group （P0.05）. Conclusion Feasibility and safety of scarred uterus re-pregnancy by vaginal delivery are clinically high enough for relieving pain in puerpera and reducing postoperative complications， and it is worthy of promotion and application. 　　【Key words】 Scarred uterus； Re-pregnancy； Vaginal delivery； Feasibility； Safety 　　瘢痕子宫是临床上常见的产科疾病， 这种疾病在剖宫产（占多数）、子宫肌瘤剥除术等术后发病率较高。随着人们生活方式的改变， 剖宫产率出现上升趋势， 使得瘢痕子宫再次妊娠者的比例逐渐升高， 剖宫产术后再次妊娠分娩方式的选择成为产科临床突出的问题， 由于再次剖宫产存在膀胱、肠管损伤、切口撕裂、产后出血、盆腔复杂粘连等风险增高， 因此更多的产妇选择阴道分娩[1]。本文探讨瘢痕子宫再次妊娠经阴道分娩的可行性以及安全性， 报告如下。 　　1 资料与方法 　　1. 1 一般资料 在本院接受分娩的60例瘢痕子宫再次妊娠经阴道分娩产妇设为实验组， 年龄19～40岁， 平均年龄（29.3±4.2）岁， 孕周35～40周， 平均孕周（37.5±2.