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目的:探讨剖宫产术后再次妊娠阴道分娩(VBAC)患者的试产成功率、产程及母婴并发症。方法:选取2012年1至2013年3月在我院行阴道分娩的剖宫产术后再次妊娠的153例产妇为研究组,同期选取行阴道分娩的200例孕足月初产妇为对照组。分析两组的阴道试产成功率、产程、母婴并发症。结果:研究组153例,试产成功130例(84.97%);对照组200例,试产成功183例(91.50%)。两组的阴道试产成功率、第一产程、第二产程及总产程、新生儿窒息率、巨大儿发生率均无显著差异(P>0.05);而第三产程时间、手取胎盘率、会阴侧切率及产后出血率均显著高于对照组(P<0.05)。结论:对有1次子宫下段横切口剖宫产史的孕妇,应给予充分的阴道试产机会,同时应积极处理第三产程,预防产后出血。
Objective: To investigate the success rate of trial production, labor process and maternal and infant complications of re-pregnant vaginal delivery (VBAC) after cesarean section. Methods: A total of 153 pregnant women who underwent vaginal delivery in our hospital from March 2012 to March 2013 underwent vaginally delivery were selected as the study group. Two hundred pregnant women of the first trimester were selected as the control group. Analysis of two groups of vaginal trial production success rate, labor process, maternal and child complications. Results: The study group of 153 cases, 130 cases of successful trial (84.97%); control group of 200 cases, trial success 183 cases (91.50%). The success rate of vaginal trial production, the first stage of labor, the second stage of labor and the total labor, neonatal asphyxia, macrosomia were no significant difference (P> 0.05); and the third stage of labor time, hand placenta accreta, perineum The rates of lateral cut and postpartum hemorrhage were significantly higher than those of the control group (P <0.05). Conclusion: For pregnant women who have a history of cesarean section in the lower uterine transverse incision, adequate vaginal trial should be given. At the same time, the third stage of labor should be actively treated to prevent postpartum hemorrhage.