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目的探讨瘢痕子宫产妇再次妊娠分娩方式的合理选择问题。方法回顾性分析2013年4月-2014年12月该院收治的135例瘢痕子宫再次妊娠产妇的临床资料,根据分娩方式分为阴道分娩组、急诊剖宫产组、择期剖宫产组,比较不同分娩方式的分娩结局情况。另按1∶2比例随机抽取同期在该院分娩的非瘢痕子宫阴道分娩产妇作为对照,并与该研究中瘢痕子宫阴道试产成功产妇的分娩结局进行比较。结果 135例瘢痕子宫患者再次妊娠产妇中选择阴道试产的有59例,其中48例阴道试产成功,试产成功率为81.36%,11例失败后进行急诊剖宫产,其余76例患者行择期剖宫产。阴道分娩组产时出血量及住院天数均显著低于急诊剖宫产组和择期剖宫产组(P<0.05);产程时间及新生儿Apgar评分均优于急诊剖宫产组(P<0.05),而新生儿Apgar评分与择期剖宫产组比较,差异无统计学意义(P>0.05)。48例瘢痕子宫再次妊娠阴道成功分娩者与同期非瘢痕子宫阴道分娩者在产时出血量、产程时间、住院天数及新生儿Apgar评分等方面比较,差异均无统计学意义(P>0.05)。结论在严格掌握经阴道分娩指征的前提下,给予瘢痕子宫产妇经阴道分娩的试产机会是安全可行的。
Objective To investigate the reasonable choice of the mode of delivery of pregnancy after scar pregnancy. Methods The clinical data of 135 pregnant women with uterine scar from April 2013 to December 2014 were retrospectively analyzed. According to the mode of delivery, they were divided into vaginal delivery group, emergency cesarean section group and elective cesarean section group. Different delivery modes of delivery outcome. Another 1: 2 ratio randomly selected during the same period in the hospital delivery of non-scarring uterine vaginal delivery of mothers as a control, and with the study of scarring uterus vaginal delivery successful maternal childbirth outcomes were compared. Results Among the 135 cases of uterine scar pregnancy, 59 cases were selected for vaginal trial. Among them, 48 cases of vaginal trial were successful, the success rate of trial production was 81.36%, emergency caesarean section was performed after 11 cases, and the remaining 76 cases Elective cesarean section. The amount of vaginal delivery during labor and the number of days of hospitalization were significantly lower than those of emergency cesarean section and elective cesarean section (P <0.05). The duration of labor and neonatal Apgar score were superior to those of emergency cesarean section (P <0.05) ), While there was no significant difference in neonatal Apgar score and elective cesarean section (P> 0.05). There were no significant differences in the amount of bleeding during labor, labor duration, length of hospital stay, Apgar score of newborns among 48 cases of successful vaginal delivery of scar pregnancy and those of non-scarring vaginal delivery in the same period (P> 0.05). Conclusion Under the premise of strictly controlling the indications of vaginal delivery, it is safe and feasible to give trial of vaginal delivery of scar-shaped uterus to pregnant women.