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瘢痕子宫是指剖宫产或肌壁间肌瘤剔除术后子宫。瘢痕子宫再次妊娠时分娩方式的选择,是目前临床关注及研究的重点。剖宫产率是衡量产科临床医疗质量的重要指标之一,对瘢痕子宫再次妊娠者若继续行重复剖宫产,则导致总剖宫产率上升;多个国家临床指南建议,对于瘢痕子宫再次妊娠者,若评估其具有阴道试产的条件,应充分鼓励进行阴道试产。本文分析了瘢痕子宫再次妊娠阴道分娩产妇90例的围生结局,旨在探讨瘢痕子宫再次妊娠阴道分娩的可行性及安全性。本组90例第一产程(5.80±3.50)h,第二产程(37.0±26.0)min,第三产程(8.0±4.0)min;总产程(6.54±3.58)h。产时出血(116.4±54.6)ml;产后1h出血(99.3±13.4)ml,产后2h出血(61.1±25.4)ml,产后24h出血(306.6±76.9)ml。住院时间(3.7±1.6)天。无一例出现产伤、产褥感染、子宫破裂等并发症。本组新生儿90例中,1min Apgar评分≥8分89例,占98.9%;5min Apgar评分、10min Apgar评分均≥8分。转新生儿科12例,占13.3%;新生儿出生体质量(3077±577)g。母儿均无一例病死。提示,瘢痕子宫再次妊娠阴道分娩可行且安全。
Scar uterus refers to the uterus after cesarean section or myometrial myomectomy. The choice of mode of delivery during scar pregnancy again is the focus of clinical attention and research. Cesarean section rate is one of the important indicators to measure the quality of obstetric clinical medical service. If repeat cesarean section is continued for those with scarred uterus again, the total cesarean section rate will increase. In many countries, clinical guidelines suggest that for uterine scar again Pregnancy, if you assess the condition of the vaginal trial, should be fully encouraged for vaginal trial. This paper analyzes the perinatal outcome of maternal 90 cases of vaginal delivery of scar pregnancy again aimed at exploring the feasibility and safety of vaginal delivery of scar pregnancy again. The 90 cases of the first stage of labor (5.80 ± 3.50) h, the second stage of labor (37.0 ± 26.0) min, the third stage of labor (8.0 ± 4.0) min; the total stage of labor (6.54 ± 3.58) h. Hemorrhage (116.4 ± 54.6) ml during labor; Hemorrhage (99.3 ± 13.4) ml at 1 h postpartum; Hemorrhage (61.1 ± 25.4) ml at 2 h postpartum and 306.6 ± 76.9 ml postpartum. Hospitalization time (3.7 ± 1.6) days. No case of birth injury, puerperal infection, uterine rupture and other complications. In this group of 90 newborns, 1 minute Apgar score ≥ 8 points and 89 cases, accounting for 98.9%; 5min Apgar score, 10min Apgar score ≥ 8 points. Twelve neonates (13.3%) were born to neonates, and birth weight (3077 ± 577) g. No one died of maternal and child. Tip, scar pregnancy uterine vaginal delivery again feasible and safe.