二次妊娠合并瘢痕子宫产妇分娩方式的危险因素分析
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摘要
目的研究影响瘢痕子宫再次妊娠产妇分娩方式的独立危险因素。方法回顾性分析2016年10月-2018年10月德阳市第二人民医院294例瘢痕子宫再次妊娠产妇临床资料,根据分娩方式将入选患者分为剖宫产后经阴道分娩(VBAC,n=109)和瘢痕子宫择期剖腹产(ERCD,n=185)两组,比较两组各项临床指标差异并采用多因素Logistic回归分析探讨其对分娩方式的影响。结果 294例瘢痕子宫再次妊娠产妇中尝试TOLAC者137例,其中完成VBAC者109例,成功率79.56%,在全部产妇中占比37.07%,经ERCD分娩者185例,占比62.93%;两组年龄、孕周、妊娠合并症、胎心异常及产妇和家属意愿差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,年龄、妊娠合并症、胎心异常及产妇和家属意愿是影响瘢痕子宫再次妊娠产妇分娩方式的独立危险因素(P<0.05)。结论影响瘢痕子宫再次妊娠产妇分娩方式的独立危险因素包括年龄、妊娠合并症、胎心异常以及产妇和家属意愿。
Objective To study the independent risk factors affecting the delivery modes of re-pregnant puerperae with scarred uterus.Methods The clinical data of 294 re-pregnant puerperae with scarred uterus in our hospital from October 2016 to October 2018 were retrospectively analyzed. According to the delivery modes, the selected patients were divided into vaginal birth after cesarean group(VBAC,n=109) and elective repeat cesarean delivery group(ERCD,n=185). The differences of clinical indicators were compared between the two groups, and the multivariate Logistics regression analysis was used to explore their effects on the delivery modes.Results Among the 294 cases of re-pregnant puerperae with scarred uterus, 137 cases tried TOLAC, of which 109 cases completed VBAC with the success rate of 79.56% and accounted for 37.07% of all women and 185 cases adopted ERCD delivery and accounted for 62.93%. There were statistically significant differences in the age, gestational age, pregnancy complications, fetal heart abnormalities and willingness of puerperae and family members between the two groups(P<0.05). Multivariate Logistics regression analysis results showed that age, pregnancy complications, fetal heart abnormalities and willingness of puerperae and family members were independent risk factors affecting the delivery modes of re-pregnant puerperae with scarred uterus(P<0.05).Conclusion Independent risk factors affecting the delivery modes of re-pregnant puerperae with scarred uterus include age, pregnancy complications, fetal heart abnormalities and willingness of puerperae and family members.
Objective To study the independent risk factors affecting the delivery modes of re-pregnant puerperae with scarred uterus.Methods The clinical data of 294 re-pregnant puerperae with scarred uterus in our hospital from October 2016 to October 2018 were retrospectively analyzed. According to the delivery modes, the selected patients were divided into vaginal birth after cesarean group(VBAC,n=109) and elective repeat cesarean delivery group(ERCD,n=185). The differences of clinical indicators were compared between the two groups, and the multivariate Logistics regression analysis was used to explore their effects on the delivery modes.Results Among the 294 cases of re-pregnant puerperae with scarred uterus, 137 cases tried TOLAC, of which 109 cases completed VBAC with the success rate of 79.56% and accounted for 37.07% of all women and 185 cases adopted ERCD delivery and accounted for 62.93%. There were statistically significant differences in the age, gestational age, pregnancy complications, fetal heart abnormalities and willingness of puerperae and family members between the two groups(P<0.05). Multivariate Logistics regression analysis results showed that age, pregnancy complications, fetal heart abnormalities and willingness of puerperae and family members were independent risk factors affecting the delivery modes of re-pregnant puerperae with scarred uterus(P<0.05).Conclusion Independent risk factors affecting the delivery modes of re-pregnant puerperae with scarred uterus include age, pregnancy complications, fetal heart abnormalities and willingness of puerperae and family members.
引文
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