目的： 探讨剖宫产术后再次妊娠分娩方式的选择及对母婴的影响。方法 回顾性分析我院2010年1月至2012年1月收治的88例有剖宫产史孕妇的分娩方式、分娩结局、母儿并发症以及医疗费用，并将其中再次剖宫产（RCS）62例与同期首次剖宫产（PCS）62例进行对照；将其中剖宫产术后阴道分娩（VBAC）26例与随机抽取非瘢痕子宫阴道分娩（VBNC）26例进行对照分析。结果 88例中39例行阴道试产，26例试产成功，成功率66.7%；RCS62例，手术产率70.5%。VBAC组先兆子宫破裂发生率、产后出血量、新生儿窒息发生率及产后病率与对照组比较差异无显著性意义（P＞0.05），而RCS组产后出血量、腹腔粘连发生率均高于PCS组，差异有显著性意义（P＜0.05）。结论 剖宫产术后再次妊娠并非剖宫产绝对指证，无试产禁忌者，并经孕妇及家属同意，在严密监护下可行阴道试产。%Objective To investigate the selection of the pregnancy childbirth way again after cesarean section and effects on maternal and infant. Methods A retrospective analysis of our hospital between January 2010 and January 2012, 88 cases of pregnant women has a history of cesarean section delivery mode, delivery outcome, the mother son complications and medical costs, and will again cesarean section (RCS) of 62 cases of cesarean section (PCS) for the ifrst time with the same period in 62 cases were compared; Of vaginal birth after cesarean section (VBAC failure), 26 cases with a random sample of scar uterus vaginal delivery (VBNC) 26 cases for contrast analysis. Results In 39 of 88 cases of vaginal trial production, 26 cases of trial-produce success, success rate of 66.7%; RCS62 example, ShouShuChan rate was 70.5%. VBAC failure group of precursor incidence of uterine rupture, postpartum blood loss, incidence of neonatal asphyxia and postpartum disease rate there was no signiifcant difference compared with control group (P>0.05), postpartum blood loss, abdominal cavity conglutination and RCS group were higher than that of PCS group, signiifcant differences (P<0.05). Conclusion Cesarean section again absolutely against pregnancy is not a cesarean delivery, no preproduction contraindication, and subject to consent by the pregnant women and their families, the vaginal trial production under the close guardianship feasible.
展开▼
