疤痕子宫妊娠妇女经产道分娩的可行性、安全性和相关危险因素分析

目的:探讨疤痕子宫妊娠妇女经产道分娩的可行性、安全性和相关危险因素。方法:选择疤痕子宫妊娠妇女120例,根据分娩方式的不同分为剖宫产组(80例)与自然分娩组(40例),观察再次剖宫产的原因与两组的预后情况。结果:再次剖宫产的指征主要为疤痕子宫(患者拒绝试产)、产程异常、胎儿窘迫、前置胎盘等。自然分娩组的产时出血量明显少于剖宫产组(P0.05),产后出血与产后感染发生率也均明显低于剖宫产组(P0.05)。两组的5分钟Apgar评分对比差异无统计学意义,但自然分娩组新生儿黄疸与新生儿湿肺发生情况明显低于剖宫产组(P0.05)。自然分娩组的分娩满意度为97.50%,剖宫产组为83.75%,自然分娩组明显高于剖宫产组(P0.05)。结论:疤痕子宫妊娠妇女经产道分娩可行性好,能减少对于产妇与新生儿的影响,安全性佳,但也要根据产妇的实际情况进行具体选择。

The Feasibility, Safety and Related Risk Factors of Pregnant Women with Scaruterus Underwent Vaginal Delivery

Objective:To investigate the feasibility, safety, and risk factors of pregnant women with scaruterus underwent vaginal delivery.Methods:120 cases of pregnant women with scaruterus were selected and divided into the cesarean section group(cesarean group, 80 cases) and natural childbirth (natural childbirth group, 40 cases) according to the mode of delivery, the causes of cesarean section again were analyzed and the prognosis of both groups were observed and compared.Results:The main indications for cesarean section again were uterine scar (patient refused pilot), labor abnormalities, fetal distress and placenta previa, et al. The bleeding in the natural childbirth group was significantly less than that of the cesarean group(P<0.05), and the incidence rates of postpartum hemorrhage and postpartuminfection were significantly lower than those of the cesarean section group (P<0.05). No statistically significant difference was found in the five minutes Apgar score between two groups, but the incidence rates of asphyxia, neonatal jaundice and neonatal wet lung in the natural childbirth group were significantly lower than those of the cesarean group(P<0.05). The satisfactory rates for childbirth of natural childbirth group and cesarean group were respectively 97.50% and 83.75%, which was significantly higher in the natural childbirth group (P<0.05).Conclusion:Pregnant women with scaruterus underwent vaginal delivery was feasible. Vaginal delivery could reduce the injury to maternal and neonatal and was also safe, but it should be selected according to the actual situation of specific maternal.