[1]李灵玲,肖准*.瘢痕子宫产妇两种分娩方式的母儿结局研究[J].中国计划生育和妇产科,2018,(１):43-46.
　LI Ling-ling,XIAO Zhun*.Study of maternal and fetal outcome of scar uterine maternal in two modes of delivery[J].Chinese Journal of Family Planning & Gynecotokology,2018,(１):43-46.
点击复制

瘢痕子宫产妇两种分娩方式的母儿结局研究
分享到：

《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2018年１期
页码:
43-46
栏目:
论著与临床
出版日期:
2018-01-25

文章信息/Info

Title:
Study of maternal and fetal outcome of scar uterine maternal in two modes of delivery
作者:
李灵玲1; 肖准2*
1.四川省妇幼保健院产科；2.四川大学华西第二医院妇产科
Author(s):
LI Ling-ling1; XIAO Zhun2*
1.Department of Obstetrics,Sichuan Provincial Hospital for Woman and Children；2.Department of Obstetrics,West China Second Hospital of Sichuan University
关键词:
瘢痕子宫; 阴道试产; 剖宫产
Keywords:
scar uterus;  vaginal trial production;  cesarean section
分类号:
R 714.2
摘要:
目的分析两种不同分娩方式对瘢痕子宫产妇妊娠结局的影响。方法选取2015年9月至2016年12月在四川省妇幼保健院产科分娩的符合阴道试产条件的110例瘢痕子宫产妇为研究对象，依据医生评估结果及产妇意愿选择分娩方式，按实际分娩结果分组。产前有36例产妇选择阴道试产，其中阴道试产成功28例为A组，阴道试产失败转为急诊剖宫产8例为B组，择期剖宫产74例为C组。比较瘢痕子宫产妇不同分娩方式的各项指标。结果A组、B组孕周和新生儿窒息、先兆子宫破裂、胎心异常的发生率比较，差异无统计学意义（P＞005）；B组新生儿出生体重（birth weight，BW）、产后感染率高于A组（P＜005）；A组、C组孕周、BW、胎心异常和产后感染的发生率比较，差异无统计学意义（P＞005）；C组新生儿窒息发生率低于A组（P＜005）；C组产后感染率低于B组（P＜005）；A组产后出血量、住院时间及产程时间均少于B组、C组，C组产后出血量、住院时间少于B组，差异均有统计学意义（P＜005）；体质量指数、两次分娩间隔时间是瘢痕子宫孕产妇再次妊娠分娩的危险因素（P＜005）。结论在瘢痕子宫产妇中应用阴道试产具有明显的优势，但其风险仍然不容忽视。
Abstract:
ObjectiveTo analyze the effects of two different modes of delivery on the pregnancy outcome of pregnant women with scarred uterus. Methods110 cases of women met the condition of vaginal trial production in Sichuan Provincial Hospital for Woman and Children from September 2015 to December 2016 were selected and the modes of delivery were chosen based on the results of the doctor's assessment and the mother's own wishes. 36 prenatal women chose vaginal trial production while 74 chose cesarean section. According to the actual delivery results they were divided into group A (28 cases of vaginal trial success), group B (8 cases of vaginal trial failed to emergency cesarean section) and group C (74 cases of elective cesarean section). Compared scar uterine maternal indicators of different modes of delivery. ResultsThere was no significant difference in the incidence of gestational age, neonatal asphyxia, threatened uterine rupture and fetal heart rate between group A and B(P> 005); The birth weight (BW) in group B was greater than that in group A, and the postnatal infection rate was also higher than in group A. The differences were statistically significant(P<005); There was no significant difference in the incidence of gestational age, BW, fetal heart rate and postnatal infection between group A and C (P<005); The incidence of neonatal asphyxia in group C was lower than that in group A, the difference was statistically significant(P<005). The postpartum infection rate in group C was significantly lower than that in group B, the difference was statistically significant(P<005). The amount of postpartum hemorrhage, length of hospital stay and labor duration in group A were significantly less than those in group B and C. Postpartum hemorrhage and hospital stay of group C were significantly less than those in group B(P<005). BMI and the interval of two births were the risk factors of childbirth of scar uterus maternal pregnant again(P<005). ConclusionVaginal delivery have obvious advantages for parturient with scar uterus, but the risk is still not to be ignored.

参考文献/References:

［1］阮焱, 张为远. 剖宫产的现状及剖宫产率高居不下的原因 ［J］. 实用妇产科杂志, 2015, 31(4):241-243. ［2］顾春怡, 丁焱, 朱新丽. 剖宫产术后阴道试产妇女的围产期评估与管理现状 ［J］. 中华护理杂志, 2015, 50(4):463-467. ［3］Agarwal A, Chowdhary P, Das V, et al. Evaluation of pregnant women with scarred uterus in a low resource setting. ［J］. Journal of Obstetrics & Gynaecology Research, 2007, 33(5):651-654. ［4］陆莹, 郑疆. 剖宫产瘢痕子宫妇女再次妊娠阴道分娩的临床观察 ［J］. 中国计划生育学杂志, 2015, 23(4):254-256. ［5］Edmonds J K, Hawkins S S, Cohen B B. Variation in vaginal birth after cesarean by maternal race and detailed ethnicity ［J］. Maternal & Child Health Journal, 2016, 20(6):1-10. ［6］孙彦飞, 方浴娟, 张薏女. 疤痕子宫再次妊娠二次剖宫产与非疤痕子宫剖宫产的对比研究 ［J］. 中国性科学, 2015，24(6):93-95. ［7］Abha S, Chandrashekhar S. Uterine Rupture: Still a harsh reality! ［J］. Journal of Obstetrics & Gynaecology of India, 2015, 65(3):1-4. ［8］Bueno L P, Folch B F, Pallarés I J, et al. Haemoperitoneum after spontaneous vaginal delivery due to uterine artery pseudoaneurysm rupture ［J］. Journal of Obstetrics & Gynaecology the Journal of the Institute of Obstetrics & Gynaecology, 2016, 36(5):1. ［9］宋永红, 常青, 陈诚,等. 剖宫产瘢痕妊娠保守治疗的相关危险因素Meta分析 ［J］. 实用妇产科杂志, 2015, 31(1):64-70. ［10］陈镘如, 梅立, 谢兰,等. 外生型剖宫产瘢痕妊娠三种治疗方法的对比研究 ［J］. 实用妇产科杂志, 2015, 31(4):278-281. ［11］荣长仙, 周晓, 王健. 200例超声在瘢痕子宫再次妊娠分娩方式选择的意义 ［J］. 重庆医学, 2015，44(19):2644-2645，2648. ［12］洪婧贞, 洪淑蓉, 胡继芬,等. 瘢痕子宫产前预测改良评分法的临床研究 ［J］. 实用妇产科杂志, 2015, 31(2):135-138. ［13］谭彬, 漆洪波. 瘢痕子宫再次妊娠阴道分娩相关问题 ［J］. 中国实用妇科与产科杂志, 2015, 31(5):421-425. ［14］廖晗甦, 杨钦灵. 瘢痕子宫再次妊娠分娩方式选择的分析 ［J］. 广东医学, 2016, 37(s1):93-95. ［15］耿慧珍, 黄佳明, 杨娟,等. 瘢痕子宫妊娠后子宫破裂16例临床分析 ［J］. 广东医学, 2016, 37(1):28-29.

相似文献/References:

[1]唐国梅.米索前列醇联合依沙吖啶终止瘢痕子宫中期妊娠的临床观察[J].中国计划生育和妇产科,2010,(02):0.
[2]王星.一次性宫腔组织吸引管用于瘢痕子宫人工流产术临床观察[J].中国计划生育和妇产科,2011,(02):0.
　WANG Xing Family Planning Service Station of Fuyang city,Fuyang Anhui 000,P.R.China.[J].Chinese Journal of Family Planning & Gynecotokology,2011,(１):0.
[3]邹敏,刘正飞.492例瘢痕子宫妊娠分娩结局临床分析[J].中国计划生育和妇产科,2011,(05):0.
　ZOU Min,LIU Zheng-fei.[J].Chinese Journal of Family Planning & Gynecotokology,2011,(１):0.
[4]闫少甫.瘢痕子宫妊娠重复剖宫产并发症的对比分析[J].中国计划生育和妇产科,2013,(03):0.
　YAN Shao - fu.[J].Chinese Journal of Family Planning & Gynecotokology,2013,(１):0.
[5]李海英,刘小瑜.瘢痕子宫妊娠经阴道分娩113例临床分析[J].中国计划生育和妇产科,2014,(06):0.
　LI Hai-ying,LIU Xiao-yu,Obstetrics.[J].Chinese Journal of Family Planning & Gynecotokology,2014,(１):0.
[6]王秀芝.曲马多配伍安定在瘢痕子宫妊娠引产中的应用[J].中国计划生育和妇产科,2014,(06):0.
　Wang Xiu-zhi,[J].Chinese Journal of Family Planning & Gynecotokology,2014,(１):0.
[7]徐焕,李笑天.瘢痕子宫再生育风险的对策[J].中国计划生育和妇产科,2014,(07):0.
[8]呼松月.河南扶沟县2007~2013年剖宫产率及剖宫产指征变化原因分析[J].中国计划生育和妇产科,2014,(08):0.
　HU Song-yue,[J].Chinese Journal of Family Planning & Gynecotokology,2014,(１):0.
[9]张丽娟.剖宫产术后再次妊娠经阴道分娩的临床观察[J].中国计划生育和妇产科,2015,(03):0.
　Zhang Li-juan,[J].Chinese Journal of Family Planning & Gynecotokology,2015,(１):0.
[10]林鑫子,黄晨玲子,罗新,等.剖宫产再次分娩子宫破裂相关危险因素的临床分析[J].中国计划生育和妇产科,2016,(07):0.
　LIN Xin-zi,HUANG Chen-lingzi,LUO Xin,et al.[J].Chinese Journal of Family Planning & Gynecotokology,2016,(１):0.
[11]梁小君*,全柳青,何进球,等.缩宫素与宫颈扩张球囊应用于瘢痕子宫阴道试产的效果观察[J].中国计划生育和妇产科,2019,(8):37.
　LIANG Xiao-jun*,QUAN Liu-qing,HE Jin-qiu,et al.Effect of oxytocin and cervical dilatation balloon on vaginal trial production of scar uterus[J].Chinese Journal of Family Planning & Gynecotokology,2019,(１):37.
[12]施艳*,董完秀,唐锦清.瘢痕子宫阴道试产失败的危险因素分析及对妊娠结局的影响[J].中国计划生育和妇产科,2020,(4):29.
　SHI Yan*,DONG Wan xiu,TANG Jin qing.Analysis of the risk factors for the failure of scar uterine vaginal trial and its effect on pregnancy outcome[J].Chinese Journal of Family Planning & Gynecotokology,2020,(１):29.

更新日期/Last Update: 2018-01-25