目的 分析二胎政策下高龄孕产妇分娩方案选择的影响因素及对分娩知识知晓情况.方法 选择2014年4月至2016年6月于四川省成都市妇女儿童中心医院妇产科病房住院分娩的高龄孕妇384例为研究对象,根据孕妇分娩方式选择分为阴道分娩组、剖宫产组.比较两组基本信息及对于分娩知识知晓情况.结果 384例孕产妇中选择阴道分娩的为238例(61.98%),选择剖宫产的146例(38.02%),而最终分娩结局为阴道分娩为243例(63.28%),剖宫产141例(36.72%).不同分娩方式选择中孕产史、前次妊娠分娩方式有显著性差异(χ2值分别为41.901、15.478,均P<0.05),而两组文化程度、职业、家庭总月收入、居住地比较均无显著性差异(χ2值分别为0.004、0.007、3.114,均P>0.05).选择阴道分娩者自然分娩的优势知晓率显著高于选择剖宫产者(χ2=13.157,P<0.05),两组对于剖宫产的指征、瘢痕子宫再次妊娠的风险知晓率均无显著性差异(χ2值分别为0.840、0.293,均P>0.05).孕产妇选择阴道分娩的主要原因为对母子健康有益(90.34%),其次为想生育二胎(80.67%),而选择剖宫产的主要原因为剖宫产相对安全(82.19%),其次为担心阴道分娩失败(68.49%),担心影响性生活(57.53%).结论 孕产妇分娩方式的选择与年龄、孕产史、前次妊娠分娩方式显著相关,孕妇对于剖宫产的指征、瘢痕子宫再次妊娠的风险知晓率均较低,需进行宣教,以降低剖宫产率.%Objective To study the influencing factors of delivery plan selection and knowledge of childbirth of elderly pregnant women under two children policy.Methods Altogether 384 cases of elderly pregnant women hospitalized for delivery in maternity ward of Chengdu Women and Children''s Center Hospital of Sichuan Province from April 2014 to June 2016 were selected as study objects and divided into vaginal delivery group and cesarean section group based on their delivery plan selection.Basic information and childbirth knowledge status between two groups were compared.Results Among 384 pregnant women, 238 cases (61.98%) chose vaginal delivery and 146 cases (38.02%) selected cesarean section.According to actual delivery outcomes, 243 cases (63.28%) underwent vaginal delivery and 141 cases (36.72%) received cesarean section.There were significant differences in gestation history and previous delivery mode between pregnant women choosing different delivery mode (χ2 value was 41.901 and 15.478, respectively, both P<0.05), but there was no significant difference in education degree, occupation, total family monthly income and residential place between two groups (χ2 value was 0.004, 0.007 and 3.114, respectively, all P>0.05).Awareness rate of spontaneous labor advantage of pregnant women choosing vaginal delivery was significantly higher than that of pregnant women choosing cesarean section (χ2 =13.157,P<0.05).There was no significant difference in awareness rate of risk of cesarean section indications and secondary pregnancy of scarred uterus between two groups (χ2 value was 0.840 and 0.293, respectively, both P>0.05).Main causes of selection of vaginal delivery by pregnant women were benefit for maternal and child health (90.34%) and desire for second child (80.67%).Main causes for choosing cesarean section were the relative safety of cesarean section (82.19%), fear for vaginal delivery failure (68.49%) and worry about influence on sexual life (57.53%).Conclusion Choice of delivery mode of pregnant women is significantly associated with age, gestation history and previous delivery mode.Awareness rate of cesarean section indications and risks of secondary pregnancy of scarred uterus is low for pregnant women, and education is needed to reduce rate of cesarean section.
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