169例瘢痕子宫再次妊娠经阴道分娩母儿结局影响的回顾性分析

目的：探讨瘢痕子宫再次妊娠经阴道分娩的母儿结局。方法：将2012年1月-2012年12月鼓楼医院169例瘢痕子宫再次妊娠的孕妇分为阴道试产组24例和剖宫产组145例，并分析两组分娩方式、产后出血量、新生儿结局及相关并发症等情况。结果：阴道试产组成功21例，成功率87．5％（21／24），阴道分娩率12．4％（21／169）；无1例发生子宫破裂；产后出血、新生儿评分及相关并发症与剖宫产组比较差异无统计学意义（P〉0．05）。结论：瘢痕子宫并非再次剖宫产的绝对指征，对于符合阴道顺产条件的，严密监控，经阴道分娩是安全可行的。

Retrospectively Analysis the Effect on Maternal and Neonatal Outcomes of 169 Cases of Uterine Scar Pregnancy Again after Vaginal Delivery

Objective： To investigate the effect on maternal and neonatal outcomes of vaginal birth after cesarean （ VBAC ） .Method： One hundred and sixty-nine women with previous cesarean section had a repeated delivery in Gulou hospital from January to December 2012 and divided into vaginal trial production group （ n = 24 ） and the cesarean section group （ n = 145 ） . Compared the differences of delivery mode, amount of postpartum bleeding, neonatal outcomes and related complications between two groups. Result： 21 eases were succeeded in vaginal trial production group, success rate was 87.5% （ 21/24 ）, and vaginal parturition rate of 12.4% （ 21/169 ） ; No one had suffered uterine rupture. There were no differences on postpartum hemorrhage and neonatal. Apgar score between the vaginal and cesarean delivery women （ P〉0.05 ） . Conclusion： Scarred uterus is not the absolute indications for repeated cesarean section. Those who meet the requirements of vaginal delivery and do not have any clear indication for cesarean can have a vaginal birth after cesarean under intensive care.