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目的研究剖宫产术后再次妊娠阴道分娩成功因素及母婴结局分析。方法选取2012年4月至2015年10月154例剖宫产术后再次分娩的孕妇为研究对象,阴道分娩成功的孕妇98例为观察组,阴道试产失败剖宫产56例为对照组。比较两组的产前资料和出血量、产褥期感染率、5 min内Apger评分、新生儿窒息发生率。结果分娩孕周、阴道分娩史、距前次剖宫产手术时间、预测新生儿体质量与剖宫产术后再次妊娠阴道分娩成功有关。观察组的出血量、产褥期感染率分别为(93.48±15.27)ml、6.1%,显著低于对照组的(154.69±22.35)ml、17.9%(P<0.05),观察组Apger评分、新生儿窒息发生率与对照组比较差异未见统计学意义(P>0.05)。结论剖宫产术后再次妊娠阴道分娩保障了母婴的安全,是新生儿的理想分娩方式。分娩孕周、阴道分娩史、距前次剖宫产手术时间、预测新生儿体质量等4个因素是剖宫产术后再次妊娠阴道分娩的成功因素,积极控制成功因素可以提高剖宫产术后再次妊娠阴道分娩的成功率。
Objective To study the successful factors of vaginal delivery after pregnancy and the analysis of maternal and infant outcomes after cesarean section. Methods A total of 154 pregnant women who delivered again after cesarean section from April 2012 to October 2015 were enrolled in this study. 98 pregnant women with successful vaginal delivery were selected as the observation group. Fifty-six cesarean sections failed as the control group. Prenatal data and blood loss, puerperium infection rate, Apger score within 5 min, incidence of neonatal asphyxia were compared between the two groups. Results gestational age of childbirth, history of vaginal delivery, cesarean section from the previous operation time, the body mass of newborn after cesarean delivery and pregnancy again after the success of vaginal delivery related. The bleeding and puerperal infection rates in the observation group were (93.48 ± 15.27) ml and 6.1%, respectively, which were significantly lower than those in the control group (154.69 ± 22.35 and 17.9%, P <0.05). The Apger score, neonatal asphyxia There was no significant difference in incidence between the two groups (P> 0.05). Conclusion Reproductive pregnancy after cesarean delivery to protect the safety of mother and baby is the ideal delivery of newborns. Childbirth gestational age, history of vaginal delivery, distance from the previous cesarean section, predicting the neonatal body mass and other four factors is the success of vaginal delivery after cesarean section again successful factors, and positive control of success factors can improve cesarean section The success rate of vaginal delivery after pregnancy again.