瘢痕子宫妊娠分娩结局分析

摘要

目的 探讨瘢痕子宫妊娠分娩方式的选择.方法 选择2014年12月至2015年12月瘢痕子宫妊娠孕妇108例,经临床筛选,按孕妇意愿,要求阴道试产22例,再次剖宫产86例.另选择同期非瘢痕子宫妊娠阴道试产(均为单胎头位)22例、首次剖宫产86例为对照组,比较两组产后出血量、产后出血率、新生儿窒息、先兆子宫破裂等.结果 两组中均无先兆子宫破裂发生,瘢痕子宫阴道试产组试产成功率、产后出血量、产后出血率、新生儿窒息率与对照组比较,差异无统计学意义(P>0.05);瘢痕子宫再次剖宫产组产后出血量、产后出血率较对照组高,差异有统计学意义(P<0.05),新生儿窒息率与对照组比较,差异无统计学意义(P>0.05).结论 瘢痕子宫并非剖宫产的绝对指征,可综合评价后在严密监护下阴道试产.%Objective To discuss the choice of delivery mode for scar uterus pregnancy.Methods 108 cases of pregnant women with scar uterine pregnancy were chosen in our hospital from December 2014 to December 2015. According to pregnant women's will and clinical screening,22 cases were vaginal trial production and 86 cases underwent caesarean section again. In addition, 22 cases of vaginal pregnancy in the same period of non vaginal vaginal delivery (both single fetal head), 86 cases of the first cesarean section were selected as the control group. The postpartum blood loss,rate of postpartum hemorrhage,neonatal asphyxia,and aura of uterine rupture were compared in the two groups.Results In the two groups no aura uterine rupture occurred,and scar uterus vaginal trial-produce group success rate,postpartum blood loss,rate of postpartum hemorrhage,neonatal asphyxia rate were compared with control group,there was no statistically significant difference(P>0.05). Scar uterine cesarean delivery group of postpartum haemorrhage amount again,postpartum hemorrhage rate were higher than control group,the difference was statistically significant(P<0.05). The neonatal asphyxia rate was compared with control group,there was no statistically significant difference(P>0.05).ConclusionsScar uterus is not absolute indication of cesarean section,and it can be evaluated by vaginal delivery after intensive evaluation.