【摘要】 目的通过观察瘢痕子宫再次妊娠产妇不同分娩方式间阴道自然分娩成功率、产程时间、产后出血量、住院时间、新生儿Apgar评分、产褥病率之间的对比分析,研究瘢痕子宫再次妊娠产妇经阴道分娩的安全性、可行性及对母婴健康的影响。方法随机抽取了2018年7月-2019年12月在我院住院的有单次剖宫产史的250例孕产妇临床病例资料进行回顾性分析,按分娩方式不同分为阴道试产组(TOLAC) 138例,其中阴道分娩成功(VBAC)133例为观察组A;随机选取同期第一次妊娠经阴道分娩产妇(VBNC)100例为对照组B;选择二次剖宫产组112例(ERCS)为对照组C。观察几组产妇自然分娩成功率、产程时间、出血量、住院时间、新生儿Apgar评分、产褥病率之间的不同。结果瘢痕子宫再次妊娠分娩(VBAC)组和非瘢痕子宫妊娠分娩(VBNC)组产妇相比,分娩成功率、产程时间、产后出血量、新生儿Apgar评分无差异;瘢痕子宫再次妊娠分娩(VBAC)组和再次剖宫产(ERCS)组产妇相比,出血量少、住院时间短、产褥病率发生率少,差异有统计学意义。结论瘢痕子宫再次妊娠产妇,在严格把握指征的情况下,阴道分娩安全可行,有益于提高产科工作质量,促进母婴健康。临床工作中应积极引导具备自然分娩条件的瘢痕子宫再次妊娠产妇选择经阴道自然分娩。更多还原

【Abstract】 Objective:We investigate the safety,feasibility and maternal and child health of vaginal delivery of scar uterus repregnancy Through the comparative analysis of natural delivery success rate,duration of labor,bleeding rate,length of hospital stay,neonatal Apgar score and puerperal disease rate among different delivery methods of scar uterus repregnancy. Methods:A retrospective analysis was conducted on the clinical data of 250 maternal patients with a single cesarean section who were admitted to our hospital from July 2018 to December 2019,According to different delivery modes,138 cases were divided into vaginal trial delivery group(TOLAC),among which 133 cases of successful vaginal delivery(VBAC) were the observation group A.A total of 100 VBNC women were randomly selected as control group B.112 patients in the second cesarean section group(ERCS) were selected as the control group C.we observed the differences of natural birth success rate,duration of labor,amount of bleeding,length of hospital stay,Apgar score and puerperal disease rate.Results:Compared with VBAC group and VBNC group,there was no difference in the success rate of delivery,duration of labor,postpartum hemorrhage and Apgar score.Compared with the repregnancy and delivery of scar uterus(VBAC)group and the redelivery of cesarean section(ERCS) group,there were less bleeding,shorter hospital stay and less incidence of puerperal disease,with statistically significant differences.Conclusion:Vaginal delivery is safe and feasible under the condition of strictly grasping the indications,which is beneficial to improve the quality of obstetrics and promote the health of mother and child.In clinical work,we should actively guide the women with scar uterus who have natural delivery conditions to choose vaginal natural delivery.更多还原