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目的探讨瘢痕子宫再次妊娠,分娩方式的选择对妊娠结局的影响。方法 60例实施分娩的瘢痕子宫再次妊娠产妇,根据选择阴道分娩或剖宫产方式不同分为瘢痕子宫阴道分娩组(21例)和瘢痕子宫剖宫产组(39例)。同时选择同期在本院分娩的非瘢痕子宫妊娠产妇60例,根据选择阴道分娩或剖宫产,分为非瘢痕子宫阴道分娩组(35例)、非瘢痕子宫剖宫产组(25例)。分析四组中阴道分娩相关临床指标(产时出血量、产程时间、新生儿Apgar评分、新生儿窒息发生率及住院时间)和剖宫产相关临床指标(产程出血量、产程时间、子宫破裂、新生儿窒息及住院时间)。结果瘢痕妊娠子宫再次妊娠阴道试产成功率为42%。瘢痕子宫阴道分娩组相关临床指标和非瘢痕子宫阴道分娩组比较,差异无统计学意义(P>0.05)。瘢痕子宫剖宫产组产时出血量(289±35)ml高于非瘢痕子宫剖宫产组(202±41)ml、瘢痕子宫剖宫产组产程时间(1.16±0.23)h、住院时间(12.6±2.1)d长于非瘢痕子宫剖宫产组(0.84±0.14)h和(8.9±1.4)d,差异均有统计学意义(P<0.05)。结论瘢痕子宫再次妊娠剖宫产发生率仍较高,此类产妇阴道试产时要掌握好适应证,及时处理产时情况,保证母婴安全。
Objective To investigate the effect of pregnancy on the outcome of pregnancy after scar pregnancy and choice of delivery mode. Methods Sixty pregnant women with scarring uterus who were delivered again were divided into vaginal delivery group (21 cases) and cesarean scar group (39 cases) according to the method of vaginal delivery or cesarean section. At the same time select 60 cases of non-scarring uterine pregnancy maternity delivered in our hospital at the same time. According to vaginal delivery or cesarean section, 35 cases were divided into non-scarring uterine vaginal delivery group and 25 cases with non-scarring uterine cesarean section. The clinical indexes related to vaginal delivery such as bleeding during labor, duration of labor, Apgar score, incidence of neonatal asphyxia and length of hospital stay in the four groups were analyzed. The clinical parameters of cesarean section (labor, duration of labor, uterine rupture, Neonatal asphyxia and length of stay). Results scar pregnancy pregnancy uterus again pregnancy vaginal trial success rate was 42%. There was no significant difference between the clinical indexes of scarring uterus vaginal delivery group and non-scarring uterus vaginal delivery group (P> 0.05). The amount of bleeding during cesarean section in cicatricial cesarean section (289 ± 35) ml was higher than that in cesarean section (202 ± 41) ml, and the cesarean section was 1.16 ± 0.23 h 12.6 ± 2.1) d was longer than that of non-scarring uterine cesarean section (0.84 ± 0.14) h and (8.9 ± 1.4) d respectively. The difference was statistically significant (P <0.05). Conclusion The incidence of cesarean section in uterus with scar pregnancy is still high. Such maternal vagina should have indications during vaginal trial, and timely treatment should be taken to ensure the safety of maternal and infant.