剖宫产后瘢痕子宫再次妊娠阴道分娩孕妇的妊娠结局分析
摘要
目的分析剖宫产后瘢痕子宫再次妊娠行阴道分娩(VBAC)的可行性及对孕妇妊娠结局的影响。方法选择江苏省淮安市妇幼保健院2015年3月至2017年12月行剖宫产术后再次妊娠阴道试产(TOLAC)孕妇159例为研究组,分为VBAC组(106例)和TOLAC失败组(53例),并选择同期非瘢痕子宫经阴道分娩孕妇120例为对照组,分析各组分娩结局的差异。结果本组VBAC成功106例,成功率66.67%;和对照组相比,VBAC组孕前BMI指数、引产比例增高、总产程缩短、新生儿出生体重略低(P <0.05);其他指标差异均无统计学意义(P>0.05);与对照组、VBAC组相比,TOLAC失败组孕妇的年龄、孕周及孕前BMI指数均显著增高,总产程延长、引产比例、产后出血比例、产后发热比例增高,产后出血量增多、新生儿出生体重较重、住院时间明显延加(P <0.05),但新生儿其他相关指标与VBAC组及对照组相比差异均无统计学意义(P>0.05)。结论剖宫产术后再次妊娠产妇经阴道分娩可行,VBAC可减少围产期并发症,降低剖宫产率,缩短住院时间,改善母婴结局。
引文
[1]李晓华,权祥菊.瘢痕子宫再次妊娠阴道分娩的安全性及阴道试产的适应证[J].检验医学与临床,2018,19(3):397-399.
[2]张晓丽,刘文慧,张惠欣,等.瘢痕子宫再次阴道分娩可行性与安全性分析[J].河北医科大学学报,2018,38(2):221-224.
[3]Bhide A,Caric V,Arulkumaran S.Prediction of vaginal birth after cesarean delivery[J].Int J Gynaecol Obstet,2016,133(3):297-300.
[4]Kayiga H,Lester F,Amuge PM,et al.Impact of mode of delivery on pregnancy outcomes in women with premature rupture of membranes after 28 weeks of gestation in a low-resource setting:A prospective cohort study[J].Plos One,2018,13(1):e0190388.
[5]Lima FV,Koutrolousotiropoulou P,Yen TY,et al.Clinical characteristics and outcomes in pregnant women with Ebstein anomaly at the time of delivery in the USA:2003-2012[J].Archives of Cardiovascular Diseases,2016,109(6-7):390-398.
[2]张晓丽,刘文慧,张惠欣,等.瘢痕子宫再次阴道分娩可行性与安全性分析[J].河北医科大学学报,2018,38(2):221-224.
[3]Bhide A,Caric V,Arulkumaran S.Prediction of vaginal birth after cesarean delivery[J].Int J Gynaecol Obstet,2016,133(3):297-300.
[4]Kayiga H,Lester F,Amuge PM,et al.Impact of mode of delivery on pregnancy outcomes in women with premature rupture of membranes after 28 weeks of gestation in a low-resource setting:A prospective cohort study[J].Plos One,2018,13(1):e0190388.
[5]Lima FV,Koutrolousotiropoulou P,Yen TY,et al.Clinical characteristics and outcomes in pregnant women with Ebstein anomaly at the time of delivery in the USA:2003-2012[J].Archives of Cardiovascular Diseases,2016,109(6-7):390-398.