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目的探讨剖宫产术后再次妊娠临产后经阴道分娩的产前评估与产程监测观察。方法选择2017年1月至2017年6月剖宫产术后再次妊娠在我院产科住院的产妇1989例中,通过查看分娩登记和翻阅病例及临床观察,剖宫产术后再次妊娠成功经阴道分娩65例,分析产前评估、产程中B超监测与观察母婴结局。结果愿意选择经阴道分娩的产妇65例,4例行会阴侧切阴道助产(胎头吸引术),2例新生儿窒息(Apgar评分4~7分),均成功经阴道分娩。结论剖宫产术后再次妊娠并非是剖宫产的绝对指征,对符合试产条件的愿意经阴道分娩的产妇,严格掌握手术指征做好经阴道分娩的评估、选择合适的分娩方式,严密监测产程进展情况,采取积极地护理措施,给予生理、心理支持、精神鼓励,可以降低剖宫产率,减少并发症,提高经阴道分娩成功率,利于产妇身体恢复、减轻经济负担。
Objective To investigate the prenatal assessment and labor monitoring of vaginal delivery after cesarean section. Methods Select January 2017 to June 2017 cesarean section after pregnancy again in our hospital obstetrics and gynecology hospitalized 1989 cases, by checking the registration and review cases of childbirth and clinical observation, pregnancy after cesarean section again successfully transvaginal Childbirth 65 cases, analysis of prenatal assessment, B-monitoring of labor and observation of maternal and child outcomes. Results Sixty-five cases of vaginal delivery were selected, 4 cases received perineal vaginal delivery (fetal head suction) and 2 neonates with asphyxia (Apgar score 4 to 7). All of them were delivered vaginally successfully. Conclusion Re-pregnancy after cesarean section is not an absolute indication of cesarean section. Maternal women who are willing to deliver vaginally under the conditions of trial production should be critically mastered the indications for transvaginal delivery and the appropriate modes of delivery should be selected. Closely monitor the progress of labor process, take active nursing measures, give physical and psychological support, encourage the spirit, can reduce the rate of cesarean section, reduce complications and improve the success rate of vaginal delivery, which will help maternal recovery and reduce the financial burden.