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目的 探讨剖宫产术后再次妊娠经阴道分娩成功的相关影响因素,同时对母婴的结局进行分析,为提升分娩质量提供参考.方法 收集2015年1月-2016年6月唐山市妇幼保健院收治的168例剖宫产术后再次妊娠经阴道试产的产妇资料进行回顾性分析,将其中试产成功的112例产妇作为观察组,试产失败的56例产妇作为对照组,利用单因素分析与多因素Logistic回归分析两组产妇的相关因素,同时对比两组母婴的结局.结果 单因素分析发现产妇的胎位、宫高、两次妊娠的间隔时间、孕周、胎儿腹围、宫颈Bishop评分以及胎儿双顶径相关因素均与分娩成功有关,多因素Logistic回归分析发现胎儿腹围、宫颈Bishop评分、孕周以及胎位与产妇的分娩成功有关.观察组产妇产后出血量、子宫破裂率以及产褥期感染率低于对照组,两组比较差异有统计学意义 (均P＜0.05),但两组新生儿的窒息率、住院率以及新生儿Apgar评分差异无统计学意义 (均P＞0.05).结论 剖宫产术后再次妊娠经阴道分娩成功的因素主要与产妇的胎儿腹围、宫颈Bishop评分、孕周以及胎位有关,在分娩前可进行严密监护与评估,尽量进行阴道分娩,从而提升分娩质量.“,”Objective To explore the related influencing factors of successful vaginal delivery in cases with subsequent pregnancy after cesarean section,analyze the outcomes of mothers and infants,provide a reference for improving delivery quality. Methods The data of 168 pregnant women giving birth to their babies via vaginal delivery successfully in subsequent pregnancy after cesarean section in Tangshan Municipal Maternal and Child Health Care Hospital was collected and analyzed retrospectively,then the cases were divided into observation group (112 cases,vaginal trial production successfully) and control group (56 cases,failing in vaginal trial production). Univariate analysis and multivariate logistic regression analysis were used to analyze the related factors in the two groups,the outcomes of mothers and infants in the two groups were compared. Results Univariate analysis showed that fetal position,height of uterine fundus,the interval time of two pregnancies,gestational week,abdominal circumference,cervical Bishop score,fetal biparietal diameter were correlated with successful delivery. Multivariate logistic regression analysis showed that abdominal circumference,cervical Bishop score,gestational week,and fetal position were correlated with successful delivery. The amount of postpartum hemorrhage,the incidence rate of hysterorrhexis and puerperal infection in observation group were statistically significantly lower than those in control group (P＜0. 05). There was no statistically significant difference in the incidence rate of neonatal asphyxia,hospitalization rate,and neonatal Apgar score between the two groups (P＞0. 05). Conclusion Successful vaginal delivery in cases with subsequent pregnancy after cesarean section are mainly related to abdominal circumference,cervical Bishop score,gestational week,and fetal position. Close monitoring and evaluation should be performed before delivery, and vaginal delivery is the first choice to improve the quality of delivery.