[1]方建红,卢伟*,梁金丽,等.剖宫产后阴道分娩的影响因素初探[J].中国计划生育和妇产科,2018,(11):67-70,74.
　FANG Jian-hong,LU Wei*,LIANG Jin-li,et al.Preliminary study on the influencing factors of vaginal delivery after cesarean section[J].Chinese Journal of Family Planning & Gynecotokology,2018,(11):67-70,74.
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剖宫产后阴道分娩的影响因素初探
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2018年11期
页码:
67-70,74
栏目:
论著与临床
出版日期:
2018-11-25

文章信息/Info

Title:
Preliminary study on the influencing factors of vaginal delivery after cesarean section
作者:
方建红1; 卢伟1*; 梁金丽1; 徐梅1; 宋爱平2; 方云云3
1. 266109山东青岛，青岛市城阳区人民医院产科；2.266109 山东 青岛，青岛市城阳区妇幼保健所妇保科；3.266000 山东 青岛，青岛市海慈医疗集团门诊部
Author(s):
FANG Jian-hong1; LU Wei1*;  LIANG Jin-li1; XU Mei1; SONG Ai-ping2; FANG Yun-yun3
1. Department of Obstetrics,Chengyang People’s Hospital of Qingdao， Qingdao Shandong 266109,P.R.China;2.Department of Women's Heatth,Qingdao Chengyang District Maternal and Child Health Care Center, Qingdao Shandong 266109,P.R.China;3. Departmemt of Outpa
关键词:
剖宫产后阴道分娩; 试产; 重复剖宫产; 影响因素
Keywords:
cesarean section after vaginal delivery;  trial production;  repeated cesarean section;  influencing factors
分类号:
R 7143
摘要:
目的探索剖宫产术后再次妊娠阴道分娩（vaginal birth after cesarean，VBAC）的影响因素。方法采用队列研究的设计方案，选取2015～2017年间在青岛市城阳区人民医院住院并进行试产的剖宫产后再次妊娠孕妇430例为研究对象。根据是否成功进行了VBAC，将产妇分为VBAC组（354例）和重复剖宫产组（76例）；采用Logistic回归模型进行多因素分析和建立预测模型。结果试产后，剖宫产后再妊娠孕妇VBAC成功率为823 %（354/430）。Logistic回归显示，产妇年龄（≥35岁 vs <30岁；OR=0354,95 % CI:0144～0873）、孕期体重增加量（OR=0932,95 % CI:0871～0998）、是否存在剖宫产指征（有 vs 无；OR=0376,95 % CI:0195～0726）、是否进行人工破膜（无 vs 有；OR=0156,95 % CI:0079～0306）以及Bishop评分（7～9分组 vs 1～3分组；OR=8561,95 % CI:3732～19635）与VBAC存在关联。即产妇年龄较小、孕期体重增加较少、无剖宫产指征、自然破膜以及Bishop评分越高则VBAC的可能性越高。结论产妇年龄、孕期体重、剖宫产指征、自然破膜以及Bishop评分是影响VBAC的主要相关因素。
Abstract:
ObjectiveTo explore the influencing factors of vaginal birth after cesarean (VBAC). MethodsUsing the design of the cohort study, pregnant women who were hospitalized after trial cesarean section in Chengyang People’s Hospital of Qingdao from 2015 to 2017 were selected as subjects. According to whether the VBAC was successful, the women were divided into VBAC group (354 cases) and repeated cesarean section (76 cases); Logistic regression model was used for multi-factor analysis and prediction model. ResultsAfter trial delivery, the success rate of VBAC in pregnant women after cesarean section was 823 % (354/430). Logistic regression showed maternal age (≥35 years vs <30 years; OR=0354, 95 % CI: 0144~0873), weight gain during pregnancy (OR=0932, 95 % CI: 0871~0998), and whether there was a cross-section indications for cesarean section (with vs no; OR=0376, 95 % CI: 0195~0726), whether artificial rupture (no vs has;OR=0156, 95 % CI: 0079~0306) and Bishop score (7~9 packets vs 1~3 packets; OR = 8561, 95 % CI: 3732~19635) are associated with VBAC. That is, the younger the maternal age, the less weight gain during pregnancy, the absence of cesarean section indications, the natural rupture of the membrane, and the higher the Bishop score, the higher the likelihood of VBAC. ConclusionMaternal age, pregnancy weight, cesarean section indication, natural rupture of membrane and Bishop score are the main factors affecting VBAC.

参考文献/References:

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相似文献/References:

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　WANG Xiang-hua*,PENG Ju-lan,LUO Xiao-yu.Clinical study on success factors and maternal - fetal outcomes of vaginal delivery after cesarean section[J].Chinese Journal of Family Planning & Gynecotokology,2017,(11):41.
[2]陈震宇,孙静莉*,陈晓明,等.剖宫产术后再次妊娠阴道分娩的妊娠结局[J].中国计划生育和妇产科,2020,(5):58.
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备注/Memo

备注/Memo:
国家自然科学基金（项目编号：81402689）；青岛市医药科研指导计划（项目编号：2016-WJZD125）；青岛市医疗卫生优秀人才培养项目资助（项目编号：青卫科教字【2017】4号）
更新日期/Last Update: 2018-11-25