影响剖宫产术后瘢痕子宫足月分娩结局的相关因素分析(1)
摘 要：目的 探讨剖宫产术后瘢痕子宫足月分娩方式的选择及影响分娩结局的因素。方法 选取我院在2015年4月～2017年3月收治的100例剖宫产后瘢痕子宫足月妊娠患者为观察组，包括阴道分娩者49例(A组)，再次剖宫产者51例(B组)。另挑选同期非瘢痕子宫足月分娩的产妇(110例)为对照组。对比A组与B组临床效果及影响瘢痕子宫妊娠结局的因素。结果 A组出血量明显少于B组，且A组新生儿Apgar评分比B组高，数据对比差异具有统计学意义(P<0.05)。观察组与对照组先兆子宫破裂、社会因素方面差异具有统计学意义(P<0.05)。结论 剖宫产后影响瘢痕子宫妊娠结局的因素的因素比较多，如先兆子宫破裂，必须对这些危险因素给予恰当的控制，方可达到改善分娩结局的目的。
关键词：剖宫产；瘢痕子宫；足月分娩；影响因素
中图分类号：R714.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.02.039
, 百拇医药
文章编号：1006-1959(2018)02-0109-02
Abstract：Objective To explore the selection of term delivery mode of scar uterus after cesarean section and the factors influencing the outcome of delivery.Methods From April 2015 to March 2017，100 cases of full term pregnancy with scar after cesarean section in our hospital were selected as observation group，including 49 cases of vaginal delivery(group A).Another 51 cases of cesarean section (group B).Another group of 110 women without scar uterus full-term delivery was selected as the control group.The clinical effect of A group and B group and the factors influencing the outcome of scar uterine pregnancy were compared.Results The amount of bleeding in group A was significantly lower than that in group B.The Apgar score of newborns in group A was higher than that in group B，and the difference was statistically significant(P<0.05).The differences between the observation group and the control group in the diagnosis of uterine rupture and social factors were statistically significant(P<0.05).Conclusion There are many factors influencing the pregnancy outcome of scar uterus after cesarean section，such as threatened uterine rupture.These risk factors must be properly controlled to improve delivery outcomes.
, 百拇医药
Key words：Cesarean section；Scar uterus；Term delivery；Influencing factors
瘢痕子宮(scarred uterus)主要是指产妇在子宫肌瘤剔除术、剖宫产及子宫穿孔修补术中形成的子宫瘢痕现象，其直接影响到再次妊娠产妇的分娩质量，是产妇产后出血、子宫破裂的高危因素，严重威胁着母婴安全[1]。瘢痕子宫妊娠是剖宫产术后的一个主要并发症，会造成孕妇子宫破裂、胎盘植入，严重的情况下还会造成孕妇死亡。瘢痕子宫妊娠的发生率随着剖宫产孕妇的增多而增加。鉴于此，本文特选取我院收治的100例剖宫产后子宫瘢痕妊娠患者为研究对象，进一步探讨瘢痕子宫再次妊娠分娩方法及影响妊娠结局的因素，现总结报道如下。
1资料与方法
1.1一般资料 收集2015年4月～2017年3月在我院进行治疗的100例剖宫产后瘢痕子宫足月妊娠的患者作为观察组，包括阴道分娩者(A组)49例和再次行剖宫产者(B组)51例，年龄22～31岁，平均年龄(22.4±1.6)岁，孕周37～44周，平均孕周(40.2±1.3)周。挑选同时期的110例非瘢痕子宫足月分娩者为对照组，年龄23～34岁，平均年龄(25.5±2.3)岁，孕周37～45周，平均孕周(40.8±1.5)周。两组患者在年龄及孕周等方面对比，差异无统计学意义(P>0.05)，具有可比性。
1.2方法 对A组和B组出血量、新生儿Apgar评分进行详细的记录，并展开对比分析。比较观察组与对照组先兆子宫破裂、胎盘早剥、子宫破裂前置胎盘、社会因素等对分娩结局的影响。
1.3评价标准[2] 新生儿出生后，医护人员根据皮肤颜色、心搏速率、呼吸、肌张力及运动、反射五项体征对新生儿窒息程度做1 min、5 min及10 min的Apgar评分，每项2分，总分10分，评分越低说明新生儿的窒息程度越高，并评估新生儿的窒息情况。满10分者为正常新生儿，评分7分以下的新生儿有轻度窒息，评分在4分以下有重度窒息。, 百拇医药(刘礼)
关键词：剖宫产；瘢痕子宫；足月分娩；影响因素
中图分类号：R714.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.02.039
, 百拇医药
文章编号：1006-1959(2018)02-0109-02
Abstract：Objective To explore the selection of term delivery mode of scar uterus after cesarean section and the factors influencing the outcome of delivery.Methods From April 2015 to March 2017，100 cases of full term pregnancy with scar after cesarean section in our hospital were selected as observation group，including 49 cases of vaginal delivery(group A).Another 51 cases of cesarean section (group B).Another group of 110 women without scar uterus full-term delivery was selected as the control group.The clinical effect of A group and B group and the factors influencing the outcome of scar uterine pregnancy were compared.Results The amount of bleeding in group A was significantly lower than that in group B.The Apgar score of newborns in group A was higher than that in group B，and the difference was statistically significant(P<0.05).The differences between the observation group and the control group in the diagnosis of uterine rupture and social factors were statistically significant(P<0.05).Conclusion There are many factors influencing the pregnancy outcome of scar uterus after cesarean section，such as threatened uterine rupture.These risk factors must be properly controlled to improve delivery outcomes.
, 百拇医药
Key words：Cesarean section；Scar uterus；Term delivery；Influencing factors
瘢痕子宮(scarred uterus)主要是指产妇在子宫肌瘤剔除术、剖宫产及子宫穿孔修补术中形成的子宫瘢痕现象，其直接影响到再次妊娠产妇的分娩质量，是产妇产后出血、子宫破裂的高危因素，严重威胁着母婴安全[1]。瘢痕子宫妊娠是剖宫产术后的一个主要并发症，会造成孕妇子宫破裂、胎盘植入，严重的情况下还会造成孕妇死亡。瘢痕子宫妊娠的发生率随着剖宫产孕妇的增多而增加。鉴于此，本文特选取我院收治的100例剖宫产后子宫瘢痕妊娠患者为研究对象，进一步探讨瘢痕子宫再次妊娠分娩方法及影响妊娠结局的因素，现总结报道如下。
1资料与方法
1.1一般资料 收集2015年4月～2017年3月在我院进行治疗的100例剖宫产后瘢痕子宫足月妊娠的患者作为观察组，包括阴道分娩者(A组)49例和再次行剖宫产者(B组)51例，年龄22～31岁，平均年龄(22.4±1.6)岁，孕周37～44周，平均孕周(40.2±1.3)周。挑选同时期的110例非瘢痕子宫足月分娩者为对照组，年龄23～34岁，平均年龄(25.5±2.3)岁，孕周37～45周，平均孕周(40.8±1.5)周。两组患者在年龄及孕周等方面对比，差异无统计学意义(P>0.05)，具有可比性。
1.2方法 对A组和B组出血量、新生儿Apgar评分进行详细的记录，并展开对比分析。比较观察组与对照组先兆子宫破裂、胎盘早剥、子宫破裂前置胎盘、社会因素等对分娩结局的影响。
1.3评价标准[2] 新生儿出生后，医护人员根据皮肤颜色、心搏速率、呼吸、肌张力及运动、反射五项体征对新生儿窒息程度做1 min、5 min及10 min的Apgar评分，每项2分，总分10分，评分越低说明新生儿的窒息程度越高，并评估新生儿的窒息情况。满10分者为正常新生儿，评分7分以下的新生儿有轻度窒息，评分在4分以下有重度窒息。, 百拇医药(刘礼)