本文選題：瘢痕子宮 + 再次妊娠��； 參考：《當(dāng)代醫(yī)藥論叢》2016年22期

【摘要】：目的 :探討不同的分娩方式對(duì)再次妊娠的瘢痕子宮患者分娩結(jié)局的影響。方法 :選取2014年1月~2016年5月期間我院婦產(chǎn)科收治的76例再次妊娠的剖宮產(chǎn)所致瘢痕子宮孕產(chǎn)婦作為研究對(duì)象。根據(jù)孕產(chǎn)婦的實(shí)際情況及個(gè)人意愿將這76例孕產(chǎn)婦分為陰道試產(chǎn)組(n=38例)與剖宮產(chǎn)組(n=38例),分別對(duì)其進(jìn)行陰道試產(chǎn)與剖宮產(chǎn)手術(shù)。然后,比較兩組孕產(chǎn)婦產(chǎn)后的出血量、產(chǎn)后并發(fā)癥的發(fā)生情況、住院的時(shí)間及新生兒Apgar評(píng)分、新生兒的窒息率、新生兒的體質(zhì)量。結(jié)果 :在38例陰道試產(chǎn)組孕產(chǎn)婦中,有31例孕產(chǎn)婦成功地順產(chǎn),其順產(chǎn)率為81.57%,有8例孕產(chǎn)婦中轉(zhuǎn)剖宮產(chǎn),其中轉(zhuǎn)剖宮產(chǎn)率為21.05%,其產(chǎn)后未發(fā)生產(chǎn)褥感染、子宮內(nèi)膜炎等并發(fā)癥。本組孕產(chǎn)婦產(chǎn)后的平均出血量為(135.6±18.7)ml,平均住院的時(shí)間為(2.7±1.9)d。在38例剖宮產(chǎn)組孕產(chǎn)婦中,有2例孕產(chǎn)婦發(fā)生了產(chǎn)褥感染,有1例孕產(chǎn)婦發(fā)生了子宮內(nèi)膜炎,其產(chǎn)后并發(fā)癥的發(fā)生率為7.89%。本組孕產(chǎn)婦產(chǎn)后的平均出血量為(264.2±22.8)ml,平均住院的時(shí)間為(3.9±2.1)d。陰道試產(chǎn)組孕產(chǎn)婦產(chǎn)后的平均出血量、平均住院的時(shí)間、產(chǎn)后并發(fā)癥的發(fā)生率均明顯低于剖宮產(chǎn)組孕產(chǎn)婦,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。陰道試產(chǎn)組新生兒的Apgar評(píng)分明顯高于剖宮產(chǎn)組,其新生兒窒息率明顯低于剖宮產(chǎn)組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 :對(duì)于再次妊娠的剖宮產(chǎn)所致瘢痕子宮的孕產(chǎn)婦,在嚴(yán)格把握其適應(yīng)癥和禁忌癥的前提下,進(jìn)行陰道試產(chǎn)可以降低其剖宮產(chǎn)率,減少其產(chǎn)后并發(fā)癥的發(fā)生率,保障母嬰的安全與健康。
[Abstract]:Objective: to investigate the effect of different delivery modes on the delivery outcome of scar uterus patients with re-pregnancy. Methods: from January 2014 to May 2016, 76 cases of cicatricial uterus caused by cesarean section in our hospital from January 2014 to May 2016 were selected as the research objects. According to the actual situation and personal wishes of the pregnant and parturient, the 76 pregnant and parturient women were divided into the vaginal trial delivery group (n = 38) and the cesarean section group (n = 38). The vaginal trial delivery and the cesarean section were performed respectively. Then, the amount of postpartum bleeding, the occurrence of postpartum complications, the time of hospitalization, the Apgar score of newborn, the asphyxia rate of newborn and the weight of newborn were compared between the two groups. Results: among 38 cases of vaginal trial delivery, 31 cases were successfully delivered smoothly, the rate of spontaneous delivery was 81.57, and 8 cases were converted to cesarean section, the rate of transition to cesarean section was 21.05%. There was no puerperal infection, endometritis and other complications after delivery. The average amount of postpartum bleeding was 135.6 鹵18.7 ml, and the average hospitalization time was 2.7 鹵1.9 days. In 38 cases of cesarean section, 2 cases had puerperal infection and 1 case had endometritis. The incidence of postpartum complications was 7.89%. The average amount of postpartum bleeding was 264.2 鹵22.8ml, and the average hospitalization time was 3.9 鹵2.1 days. The average amount of postpartum bleeding, the average length of hospitalization and the incidence of postpartum complications in the vaginal trial delivery group were significantly lower than those in the cesarean section group, and the difference was statistically significant (P 0.05). The Apgar score in vaginal trial delivery group was significantly higher than that in caesarean section group, and the neonatal asphyxia rate was significantly lower than that in caesarean section group (P 0.05). Conclusion: for pregnant women with scar uterus caused by cesarean section, vaginal trial delivery can reduce the rate of cesarean section and the incidence of postpartum complications under strict control of indications and contraindications. To ensure the safety and health of mother and child.
【作者單位】： 錦江區(qū)婦幼保健院;
【分類號(hào)】：R714.4

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