瘢痕子宫再次妊娠阴道分娩的可行性及安全性评价(1)
摘 要：目的 评价瘢痕子宫再次妊娠阴道分娩的可行性及安全性。方法 回顾分析2016年1月～2017年12月在南华大学附属常德医院产科分娩的180例瘢痕子宫再次妊娠产妇临床资料为观察组，并选取同期在我院分娩的180例非瘢痕妊娠产妇为对照组，两组产妇均进行阴道分娩试产，对比两组产妇分娩方式、新生儿评分以及产后并发症等情况。结果 观察组阴道分娩率于对照组相比，差异无统计学意义(P>0.05)；观察组阴道分娩产程时间、出血量、新生儿Apgar 评分、住院时间与对照组对比，差异无统计学意义(P>0.05)；观察组感染、尿潴留、宫裂出血发生率等并发症发生率与对照组对比，差异无统计学意义(P>0.05)。结论 瘢痕子宫再次妊娠孕妇只要进行严密的产前检查，采用正确的助产手段，行阴道分娩完全可行，且不会增加不良反应，避免了再次剖宫产对产妇子宫造成的损伤。
关键词：瘢痕子宫；妊娠；阴道分娩；安全性
中图分类号：R714.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.06.033
, 百拇医药
文章编号：1006-1959(2018)06-0104-02
Feasibility and Safety Evaluation of Vaginal Delivery after Re-pregnancy in Scared Uterus
ZHANG Zhao-xia
(Department of Obstetrics，Changde Hospital Affiliated to Nanhua University，Changde 415000，Hunan，China)
Abstract：Objective To evaluate the feasibility and safety of vaginal delivery of scared uterus in re-pregnancy.Methods From January 2016 to December 2017，180 pregnant women with scarred uterus who were delivered in obstetrics department of Changde Hospital affiliated to Nanhua University were retrospectively analyzed as observation group，and 180 cases of non-scar pregnancy in the same period were selected as control group，the two groups of women all carried out vaginal delivery trial production，compared the two groups of parturients delivery，neonatal scores and postpartum complications.Results There was no significant difference in vaginal delivery rate between the observation group and the control group(P>0.05).There was no significant difference in vaginal delivery time， blood loss，neonatal Apgar score，and hospital stay between the observation group and the control group(P>0.05).The incidence of complications such as infection，urinary retention，and uterine fissure in the observation group was not significantly different from that in the control group(P>0.05).Conclusion It is feasible to perform vaginal delivery with strict antenatal examination and correct midwifery for pregnant women with second trimester of scar uterus，and no adverse reactions will be increased，thus avoiding the damage to the uterus caused by cesarean section.
, 百拇医药
Key words：Scar uterus；Pregnancy；Vaginal delivery；Safety
瘢痕子宫(scarred uterus)是指剖宫产手术或肌壁间肌瘤剥除术后的子宫。瘢痕子宫对再次妊娠的孕期和分娩及产后等过程有较大影响[1]。剖宫产会不可避免地对母婴产生影响，甚至会增加并发症的发生，剖宫产术是子宫瘢痕形成的最主要原因。瘢痕子宫再次妊娠通常会认为仍需行剖宫产术，但是随着医护水平的不断提高，采用阴道分娩成功率不断提高，改变了剖宫产再次妊娠必须行剖宫产的情况[2]。所以，瘢痕子宫再次妊娠阴道分娩的可行性及安全性成为研究重点。本文作者结合2016年1月～2017年12月在我分娩的180例瘢痕子宫再次妊娠产妇临床资料，对比评价瘢痕子宫再次妊娠阴道分娩的可行性及安全性。现报告如下。
1资料与方法
1.1一般资料 回顾分析2016年1月～2017年12月在南华大学附属常德医院产科分娩的180例瘢痕子宫再次妊娠产妇临床资料为观察组，并选取同期在我院分娩的180例非瘢痕妊娠产妇为对照组。本次研究经过医院伦理委员会批准。纳入标准：①年龄23～38岁；②均行子宫下段横切剖宫产术，切口无延裂，术后恢复良好，无切口感染；③未出现剖宫产手术指征[3]；④剖宫产的手术恢复时间均在2 年以上；⑤所有患者均签署知情同意书。观察组产妇年龄24～38岁，平均年龄(24.70±1.11)岁，孕周38～42周，平均孕周(38.45±0.50)周。对照组产妇年齡23～36岁，平均年龄(24.21±1.04)岁，孕周38～41周，平均孕周(39.01±1.11)周。两组产妇在年龄、孕周等基础资料方面差异无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(张朝霞)
关键词：瘢痕子宫；妊娠；阴道分娩；安全性
中图分类号：R714.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.06.033
, 百拇医药
文章编号：1006-1959(2018)06-0104-02
Feasibility and Safety Evaluation of Vaginal Delivery after Re-pregnancy in Scared Uterus
ZHANG Zhao-xia
(Department of Obstetrics，Changde Hospital Affiliated to Nanhua University，Changde 415000，Hunan，China)
Abstract：Objective To evaluate the feasibility and safety of vaginal delivery of scared uterus in re-pregnancy.Methods From January 2016 to December 2017，180 pregnant women with scarred uterus who were delivered in obstetrics department of Changde Hospital affiliated to Nanhua University were retrospectively analyzed as observation group，and 180 cases of non-scar pregnancy in the same period were selected as control group，the two groups of women all carried out vaginal delivery trial production，compared the two groups of parturients delivery，neonatal scores and postpartum complications.Results There was no significant difference in vaginal delivery rate between the observation group and the control group(P>0.05).There was no significant difference in vaginal delivery time， blood loss，neonatal Apgar score，and hospital stay between the observation group and the control group(P>0.05).The incidence of complications such as infection，urinary retention，and uterine fissure in the observation group was not significantly different from that in the control group(P>0.05).Conclusion It is feasible to perform vaginal delivery with strict antenatal examination and correct midwifery for pregnant women with second trimester of scar uterus，and no adverse reactions will be increased，thus avoiding the damage to the uterus caused by cesarean section.
, 百拇医药
Key words：Scar uterus；Pregnancy；Vaginal delivery；Safety
瘢痕子宫(scarred uterus)是指剖宫产手术或肌壁间肌瘤剥除术后的子宫。瘢痕子宫对再次妊娠的孕期和分娩及产后等过程有较大影响[1]。剖宫产会不可避免地对母婴产生影响，甚至会增加并发症的发生，剖宫产术是子宫瘢痕形成的最主要原因。瘢痕子宫再次妊娠通常会认为仍需行剖宫产术，但是随着医护水平的不断提高，采用阴道分娩成功率不断提高，改变了剖宫产再次妊娠必须行剖宫产的情况[2]。所以，瘢痕子宫再次妊娠阴道分娩的可行性及安全性成为研究重点。本文作者结合2016年1月～2017年12月在我分娩的180例瘢痕子宫再次妊娠产妇临床资料，对比评价瘢痕子宫再次妊娠阴道分娩的可行性及安全性。现报告如下。
1资料与方法
1.1一般资料 回顾分析2016年1月～2017年12月在南华大学附属常德医院产科分娩的180例瘢痕子宫再次妊娠产妇临床资料为观察组，并选取同期在我院分娩的180例非瘢痕妊娠产妇为对照组。本次研究经过医院伦理委员会批准。纳入标准：①年龄23～38岁；②均行子宫下段横切剖宫产术，切口无延裂，术后恢复良好，无切口感染；③未出现剖宫产手术指征[3]；④剖宫产的手术恢复时间均在2 年以上；⑤所有患者均签署知情同意书。观察组产妇年龄24～38岁，平均年龄(24.70±1.11)岁，孕周38～42周，平均孕周(38.45±0.50)周。对照组产妇年齡23～36岁，平均年龄(24.21±1.04)岁，孕周38～41周，平均孕周(39.01±1.11)周。两组产妇在年龄、孕周等基础资料方面差异无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(张朝霞)