[1]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):29-32.
　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,(4):29-32.
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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
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2020年4期
页码:
29-32
栏目:
论著与临床
出版日期:
2020-04-25

文章信息/Info

Title:
Analysis of the risk factors for the failure of scar uterine vaginal trial and its effect on pregnancy outcome
作者:
施艳*; 董完秀; 唐锦清
桂林市妇幼保健院产科
Author(s):
SHI Yan*; DONG Wanxiu; TANG Jinqing
Department of Obstetrics，Maternal and Child Health Hospital of Guilin,Guilin Guangxi 541001,P.R.China
关键词:
瘢痕子宫; 阴道试产; 危险因素; 妊娠结局
Keywords:
scarred uterus;  vaginal trial production;  risk factors;  pregnancy outcome
分类号:
R 714.4
摘要:
目的 分析瘢痕子宫阴道试产失败的危险因素及对妊娠结局的影响，为提高产妇分娩的安全性提供指导。方法 回顾性分析2018年1月至2019年6月桂林市妇幼保健院收治的150例瘢痕子宫再次妊娠分娩的产妇，根据阴道试产情况，将其分为阴道试产成功组127例和阴道试产失败组23例，对比两组的年龄、体质量指数（body mass index,BMI）、合并癌症、剖宫产史、子宫破裂史等因素，将其中有统计学差异的指标进行多因素 Logistic回归分析，并分析阴道试产失败对妊娠结局的影响。 结果 单因素分析结果显示:两组在年龄、孕前BMI、胎儿体重、子宫下段瘢痕厚度、子宫破裂史、先兆子宫破裂、宫缩情况、产程停滞、胎儿宫内窘迫方面比较，差异均有统计学意义（P＜005）。Logistic分析结果显示：孕前BMI、胎儿体重、子宫下段瘢痕厚度、先兆子宫破裂、宫缩乏力、产程停滞、胎儿宫内窘迫是阴道试产失败的独立危险因素，差异有统计学意义（P＜005）。阴道试产成功组的产程时间、产后出血量、新生儿Apgar评分、产褥病率、子宫破裂率优于阴道试产失败组，差异均有统计学意义（P＜005）。 结论 孕前BMI、胎儿体重、子宫下段瘢痕厚度、先兆子宫破裂、宫缩乏力、产程停滞、胎儿宫内窘迫均是导致孕妇阴道试产失败的影响因素，应根据孕妇的身体情况和具体手术指征选择合适的分娩方式，以降低不良妊娠结局。
Abstract:
ObjectiveAnalyze the risk factors for the failure of scar uterine vaginal delivery and its effect on pregnancy outcomes, and provide guidance for improving the safety of maternal delivery. Methods A retrospective analysis of 150 women with scarred uterus and pregnant women who were admitted to Maternal and Child Health Hospital of Guilin from January 2018 to June 2019. Based on the success of vaginal trials, the women with scarred uterus and pregnant women were divided into vaginal trials 127 cases in the successful group and 23 cases in the vaginal trial failure group. The age, body mass index, combined cancer, history of cesarean section, and history of uterine rupture were compared and analyzed in the two groups, and the statistically different indicators were compared by multivariate Logistic Regression analysis. The effects of failed vaginal delivery on pregnancy outcome were analyzed. ResultsThe univariate analysis showed that the differences of age, BMI before pregnancy, fetal weight, scar thickness in the lower uterus, history of uterine rupture, threatened uterine rupture uterine centractions, fetal distress between the two groups was statistically significant （P<0.05）. Logistic analysis results showed that: BMI before pregnancy, fetal weight, scar thickness in the lower uterus, threatened uterine rupture, weak uterine contraction, stagnation of labor, and intrauterine distress were independent risk factors for vaginal trial delivery failure, the differences were statistically significant （P<0.05）. The delivery time, postpartum hemorrhage, neonatal Apgar score, puerperal disease rate, and uterine rupture rate in the successful vaginal trial delivery group were better than those in the failed vaginal trial delivery group （P<0.05）. Conclusion Prepregnancy BMI, fetal weight, scar thickness in the lower uterus, threatened uterine rupture, weak uterine contraction, stagnation of labor, and intrauterine distress are all influential factors that lead to the failure of vaginal trial delivery of pregnant women. Choose the right delivery method according to the physical condition of the pregnant women and specific surgical indications to reduce adverse pregnancy outcomes.

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备注/Memo

备注/Memo:
广西壮族自治区卫生和计划生育委员会自筹经费科研课题（项目编号：Z 20180158）
更新日期/Last Update: 2020-04-25