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目的 :探讨临床上行剖宫产手术的孕妇术后瘢痕子宫足月妊娠阴道试产的可行性。方法 :我们对2014年4月-2015年8月期间我院收治的180例瘢痕子宫再次妊娠的孕妇的临床资料进行回顾性研究。我们经临床调查,按照这些孕妇是否愿意经阴道试产的原则分为实验组和对照组,并保持这两组孕妇的数量一致。实验组的孕妇为再次妊娠后愿意经阴道试产的孕妇,对照组为再次进行剖宫产手术的孕妇。之后按照孕妇的各自意愿进行分娩,之后对孕产妇的自身情况及新生儿情况进行对比观察。结果 :经过观察和统计,实验组中有51例孕产妇阴道试产成功,其余未能成功阴道试产的孕妇均经过剖宫产成功分娩,实验组孕产妇的产后出血量以及住院时间均明显要短于另一组孕妇,二者相比具有明显的差异性(p<0.05),此外,所有二组孕妇的新生儿评分及窒息情况之间并明显的差异,无统计学意义(p>0.05)。结论 :临床上对剖宫产术后瘢痕子宫再次妊娠的孕产妇来说,因根据其意愿和自身的实际情况来选择最为合适的分娩方法,并鼓励其进行阴道试产,以求尽可能的保护产妇及新生儿。如果在阴道试产过程中出现不良指征,应立即转为剖宫产方式进行分娩。
Objective: To investigate the clinical feasibility of cesarean section in pregnant women with cesarean section full-term pregnancy after vaginal trial. METHODS: We retrospectively reviewed the clinical data of 180 pregnant women with uterine scar pregnancy who were treated in our hospital from April 2014 to August 2015. Our clinical investigation, according to whether the pregnant women are willing to test the principle of vaginal delivery is divided into experimental group and control group, and to maintain the same number of pregnant women in both groups. Pregnant women in the experimental group were pregnant women who were willing to undergo vaginal trial after pregnancy again. The control group was pregnant women who had cesarean section again. Followed by the wishes of pregnant women after childbirth, after maternal and neonatal conditions of their own comparison. Results: Through the observation and statistics, 51 cases of vaginal delivery in the experimental group were successful, and the other pregnant women who failed the successful vaginal delivery were successfully delivered by cesarean section. The postpartum hemorrhage and length of stay in the experimental group were all significant (P <0.05). In addition, there was no significant difference between the neonatal scores and asphyxia in all two groups of pregnant women (p> 0.05). Conclusion: For pregnant women with cesarean scar pregnancy after cesarean section clinically, the most suitable method for delivery is selected according to their wishes and their own actual conditions, and it is encouraged to carry out vaginal trial production in order to try its best Protection of mothers and newborns. If the vaginal trial during the emergence of adverse indications, should be immediately converted to cesarean delivery.