【摘要】 目的探讨瘢痕子宫阴道分娩的并发症并进行分析。方法选择2014年1月~2016年1月龙华新区中心医院产科收治的孕周在37~42周孕妇180例,其中对照组90例为非瘢痕子宫妊娠者,观察组90例为瘢痕子宫再次妊娠者,两组孕妇均采用阴道自然分娩,对两组患者的妊娠结局及产后并发症进行比较分析。结果瘢痕子宫经阴道分娩患者产后患子宫内膜炎、产褥期感染及住院时间长短等方面与非瘢痕子宫自然分娩患者相比差异无统计学意义(P>0.05)。此外,两组患者相比,观察组产后24h出血量及阴道助产略多于对照组,且观察组出现先兆子宫破裂的情况较对照组略多,但两组之间进行比较,差异无统计学意义(P>0.05)。结论瘢痕子宫再次妊娠患者,在充分掌握阴道试产的禁忌症与适应症的情况下,采取有效预防措施、密切监护并及时发现处理的情况下可经阴道分娩,虽有并发症的发生但与非瘢痕子宫自然分娩相比并发症的发生率在可控范围内,因此,瘢痕子宫在符合阴道分娩、产妇自身条件允许的条件下鼓励其经阴道试产。更多还原

【Abstract】 Objective To study the complications in vaginal deliveries of pregnant women with scarred uteruses. Methods 180 women with pregnancies between 37 to 42 weeks who were in the obstetrical department of Shenzhen Longhua New District Central Hospital from January 2014 to January 2016 were selected, 90 pregnant women with normal uteruses were assigned to control group,90 re-pregnant women with scarred uteruses were assigned to observation group. Both two groups adopted spontaneous vaginal deliveries,the delivery outcomes and postpartum complications of the two groups were compared and analyzed. Results The puerperal endometritis rates, obstetric infection rates, and hospitalization time of the two groups were not obviously different(P > 0.05).In the observation group,the bleeding amount within 24 hours after delivery,midwifery proportion,and threatened uterus rupture rate were more or higher than those of the control group, while the differences were not obvious(P > 0.05),there were no statistical significances. Conclusion Based on fully grasping of the contraindications and indications by vaginal birth trial,with effective preventions, carefully monitoring, and timely discovery & processing mechanism, the repregnant women with scarred uteruses can adopt spontaneous vaginal deliveries.Though some re-pregnant women with scarred uteruses suffered complications,compared with the pregnant women with normal uteruses, the incidence of complications is still within a controllable range.Therefore, we recommend re-pregnant women with scarred uteruses attempting vaginal deliveries,if they meet vaginal delivery conditions and physical conditions.更多还原