剖宫产再孕分娩方式的探讨

目的:探讨剖宫产术后再次妊娠分娩方式的选择。方法:对2009年1月-2012年1月剖宫产术后再次妊娠698例在我院住院分娩的孕妇资料进行分析。并将剖宫产再孕阴道分娩的186例患者与同期随机抽取的剖宫产再孕择期剖宫产186例进行产时出血量,产后发热,住院天数,新生儿窒息,住院费用等的比较。结果:剖宫产再孕阴道试产260例,占37.2%;成功186例,成功率71.5%;试产失败74例,总手术产率73.4%。再孕剖宫产组较阴道分娩组出血量多,产后发热病例多,住院时间长,母体远期并发症多,而新生儿窒息的发生无显著性差异。结论:剖宫产再孕如合理掌握试产指征,临产后加强监测,阴道试产安全可行且试产成功率高,因此剖宫产术后再孕有试产条件的患者应给予试产的机会。

An investigation on delivery patterns of repeated pregnancy after cesarean section

Objective:To investigate the delivery patterns of repeated pregnancy after cesarean section. Methods: The data of 698 women with cesarean section who were pregnant again in our hospital from Jan 2009 to Jan 2012 was analysed. In blood loss during childbirth ,postpartum fever,hospitalization days,neonatal asphyxia,hospitalization expense etc were compared between 186 women who chosen vaginal delivery and 186 women who chosen cesarean section again. Results: There were 260 cases of vaginal trial-birth after cesarean,account for 37.2%;186 successful cases,success rate was 71.5%;74 failed cases.The total operation rate was 73.4%. Compared with vaginal trial-birth,cesarean section again lost more blood,had more postpartum fever cases,spent more hospitalization time,and the mother will face more long-term complications,but there was no obvious difference of neonatal asphyxia. Conclusion: Repeated pregnancy after cesarean section need master a reasonable indication, strengthen surveillance after the birth.Vaginal trial-birth is safe and feasible with high successful rate,so we should give opportunities to the repeated pregnancy after cesarean section patients who have the production condition.