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目的探讨瘢痕子宫再次妊娠分娩方式的选择,是否确需“一次剖宫产,永远剖宫产”。方法回顾性分析2008年2月至2010年10月21例瘢痕子宫再次妊娠产妇的分娩方式,并与非瘢痕子宫、顺产的产妇30例进行分娩过程中出血量、产程时间、新生儿Apgar评分进行比较。结果 21例瘢痕子宫产妇中19例(90.48%)阴道试产分娩成功,与非瘢痕子宫的产妇比较,分娩过程中出血量〔(121.30±10.02)vs(122.05±10.14)ml〕、产程〔(8.71±1.21)vs(9.44±1.05)h〕、新生儿Apgar评分8～10分发生率(78.9%vs 80.0%)差异均无统计学意义(P均>0.05);余2例产妇因瘢痕子宫外的原因行剖宫产术。结论有剖宫产或子宫手术史的产妇再次妊娠后剖宫产并非唯一的分娩方式,应遵循减少干预、回归自然的原则,在严密监测、严格掌握指征的前提下,阴式分娩同样是瘢痕子宫再次妊娠的首选分娩方式。
Objective To investigate the choice of mode of delivery of scar pregnancy after pregnancy again, whether it is necessary or not “once cesarean section, cesarean section forever”. Methods A retrospective analysis of 21 pregnant women with scarring uterus from February 2008 to October 2010 was performed with delivery mode, and with non-scarring uterus, 30 cases of spontaneous delivery of labor during delivery of blood loss, labor duration, neonatal Apgar score Compare Results In 21 cases of uterine scar, 19 cases (90.48%) had successful vaginal trial and childbirth, compared with the non-scar maternal women, the amount of bleeding during delivery was (121.30 ± 10.02) vs (122.05 ± 10.14) ml, 8.71 ± 1.21 vs 9.44 ± 1.05 h, respectively. There was no significant difference in the incidence of neonatal Apgar score between 8 and 10 (78.9% vs 80.0%, P> 0.05) The reason for the line cesarean section. Conclusion Cesarean section or uterine surgery history of maternal cesarean section after the second pregnancy is not the only mode of delivery, should follow the principle of reducing intervention, return to nature, under strict monitoring, strictly on the premise of indications, vaginal delivery is the same Scar pregnancy again uterine preferred delivery method.