剖宫产后瘢痕子宫再次妊娠不同分娩方式对母婴结局的影响
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摘要
目的:探究剖宫产后瘢痕子宫再次妊娠分娩方式的选择对母婴结局的影响。方法:100例剖宫产后瘢痕子宫再次妊娠产妇根据分娩方式分为观察组48例(阴道试产分娩)和对照组52例(剖宫产分娩),比较两组产妇临床相关指标、产妇并发症及新生儿并发症。结果:相较于对照组,观察组产后24h出血量较少,住院时间较短,新生儿1分钟Apgar评分较高(P<0.05);产妇盆腔粘连、产褥病、新生儿肺炎发生率均较低,差异具有统计学意义(P<0.05);两组新生儿窒息、病理性黄疸发生率相比,差异无统计学意义(P>0.05)。结论:对于符合阴道分娩指征的瘢痕子宫再次妊娠产妇采用阴道分娩,可减少产妇产后24h出血量,降低产妇并发症和新生儿肺炎率发生率,有利于改善母婴结局。
Objective: To investigate the effects of delivery modes on mother-fetus outcome in scarred uterus with subsequent pregnancy after cesarean section. Methods: 100 scarred uterus pregnant women with subsequent pregnancy after cesarean section were divided into observation group(vaginal trail delivery, n=48) and control group(cesarean section delivery, n=52) according to delivery modes. The clinical indexes, maternal complications, neonatal complications were compared between the two groups. Results: Compared with control group, the postpartum 24 h bleeding volume of observation group was less, the hospital stays of observation group were shorter, the 1 min Apgar score of observation group was higher(P <0.05). The incidence of pelvic adhesion, puerperalism, neonatal pneumonia in observation group were obviously lower than that in control group(P<0.05). There was no statistical difference in the incidence of neonatal asphyxia and pathologic jaundice between the two groups(P>0.05). Conclusions: As for scarred uterus pregnant women with subsequent pregnancy after cesarean section having vaginal delivery indicators, vaginal delivery can decrease postpartum 24 h bleeding volume, reduce the incidence of maternal complications and neonatal pneumonia, improve mother-fetus outcome.
Objective: To investigate the effects of delivery modes on mother-fetus outcome in scarred uterus with subsequent pregnancy after cesarean section. Methods: 100 scarred uterus pregnant women with subsequent pregnancy after cesarean section were divided into observation group(vaginal trail delivery, n=48) and control group(cesarean section delivery, n=52) according to delivery modes. The clinical indexes, maternal complications, neonatal complications were compared between the two groups. Results: Compared with control group, the postpartum 24 h bleeding volume of observation group was less, the hospital stays of observation group were shorter, the 1 min Apgar score of observation group was higher(P <0.05). The incidence of pelvic adhesion, puerperalism, neonatal pneumonia in observation group were obviously lower than that in control group(P<0.05). There was no statistical difference in the incidence of neonatal asphyxia and pathologic jaundice between the two groups(P>0.05). Conclusions: As for scarred uterus pregnant women with subsequent pregnancy after cesarean section having vaginal delivery indicators, vaginal delivery can decrease postpartum 24 h bleeding volume, reduce the incidence of maternal complications and neonatal pneumonia, improve mother-fetus outcome.
引文
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[3]李爱莲,王晓红,陈志燕.剖宫产疤痕子宫再次妊娠分娩方式对母婴结局的影响[J].现代仪器与医疗,2016,22(3):89-90.
[4]舒从爱,张丽容,孔小燕,等.剖宫产后瘢痕子宫妊娠早产经阴道分娩的可行性与安全性[J].海南医学,2018,29(4):547-549.
[5]胡文娟.瘢痕子宫再次妊娠经阴道分娩的临床效果及安全性研究[J].实用心脑肺血管病杂志,2016,24(1):76-77.
[6]王安,徐优文,吴晓荣.剖宫产术后瘢痕子宫再次妊娠阴道分娩的可行性研究[J].西部医学,2017,29(5):666-669.
[7]何镭,陈锰,何国琳,等.剖宫产术后再次妊娠阴道分娩孕妇的妊娠结局分析[J].中华妇产科杂志,2016,51(8):586-591.
[8]张桂英,赵双英,陈月花,等.瘢痕子宫再次妊娠产妇不同分娩方式对母婴的影响研究[J].检验医学与临床,2015,12(4):537-538.
[9]杨春华,李静,张家树.剖宫产术后子宫瘢痕妊娠经阴道分娩67例临床分析[J].实用临床医药杂志,2016,20(13):220-221.
[10]刘星,刘俊丽.瘢痕子宫再次妊娠分娩方式临床分析[J].陕西医学杂志,2015,44(120):1639-1641.