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目的探讨研究瘢痕子宫再次阴道分娩的安全性及分娩过程中子宫破裂的早期识别与诊断方法。方法选择佛山市妇幼保健院2013年6月-2016年6月的68名瘢痕子宫再次妊娠的产妇作为观察组,同期所有剖宫产再孕计划手术者52人作为对照组。观察组产妇拟采用阴道分娩,设专人密切观察产程进展,对照组产妇常规采用剖宫产。比较两组新生儿1min Apgar评分,产妇的产后出血、产褥感染及住院时间。结果观察组经阴道成功分娩46例,成功率为67.65%,两组新生儿1 min Apgar评分比较,产妇产后出血情况比较差异无统计学意义(P>0.05);产褥感染和住院时间观察组明显少于对照组,差异均有统计学意义(P<0.05)。结论只要做好对瘢痕子宫孕妇产程的观察,掌握好子宫破裂的早期诊断要点,做到及时识别和干预,本研究认为瘢痕子宫孕妇阴道分娩的安全性较高,可以根据孕妇的具体身体素质和意愿选择给予阴道试产。
Objective To study the safety of uterine scar re-vaginal delivery and early identification and diagnosis of uterine rupture during labor. Methods Seventy-eight pregnant women with scar pregnancy in Foshan Maternal and Child Health Care Hospital from June 2013 to June 2016 were selected as the observation group. All the 52 pregnant women who underwent cesarean pregnancy were enrolled as control group. The observation group maternal intends to use vaginal delivery, set up a close observation of labor progress, the control group maternal use of cesarean section. Apgar score of 1 minute, maternal postpartum hemorrhage, puerperal infection and hospital stay were compared between the two groups. Results 46 cases of vaginal successfully delivered observation group, the success rate was 67.65%, two groups of newborns 1 min Apgar score, maternal postpartum hemorrhage was no significant difference (P> 0.05); puerperal infection and hospitalization observation group Significantly less than the control group, the difference was statistically significant (P <0.05). Conclusion As long as the observation of the uterine maternal labor process is well done and the early diagnosis points of uterine rupture are well understood and timely identified and intervened, this study suggests that the safety of vaginal delivery of scar uterus pregnant women is high, according to the specific physical quality of pregnant women and Will choose to give vaginal trial production.