150例阴道试产中转剖宫产影响因素和指征分析

目的:探讨各种影响因素与阴道试产中转剖宫产的关系。方法:采用病例对照研究的方法,调查阴道试产中转剖宫产和顺产两组人群的相关信息,经单因素和多因素分析筛选剖宫产的影响因素。结果:条件Logistic分析表明孕妇年龄、生产次数、新生儿体重3个因素与阴道试产中转剖宫产有关,而临床诊断中妊娠合并症(如妊娠期糖尿病、妊娠合并甲低、妊娠合并甲亢、子痫前期等)、胎儿窘迫、产程停滞、头盆不称、疤痕子宫及引产失败占阴道试产中转剖宫产客观原因的59.3%,另有42.0%的主观因素(包括无法耐受疼痛、双胎、珍贵儿、担心母婴安全等)也是选择剖宫产的重要因素。结论:阴道试产中转剖宫产率的增加是客观因素和主观因素共同影响的结果,要采用综合的方式加以处理。

Analysis on influencing factors and indications of conversion to cesarean section during vaginal trial production in 150 cases

Objective:To explore the relationship between various influencing factors and conversion to cesarean section during vaginal trial production.Methods:A case control study was conducted to investigate the basic data of cases of conversion to cesarean section during vaginal trial production and cases of spontaneous labor,then the influencing factors of cesarean section were analyzed and screened by univariate and multivariate logistic regression analysis.Results:Conditional logistic analysis showed that maternal age,parity,and neonatal weight were correlated with conversion to cesarean section during vaginal trial production,but pregnancy complications(gestational diabetes mellitus,pregnancy combined with hypothyroidism,preeclampsia),fetal distress,arrested labor,cephalopelvic disproportion,scarred uterus,and unsuccessful induced labor accounted for 59.3% of objective factors of cesarean section during vaginal trial production,subjective factors(including intolerant pain,twin,precious babies,worrying about maternal and infantile safety) accounted for 42.0% of the factors of cesarean section during vaginal trial production.Conclusion:The increase of cesarean section during vaginal trial production is the results of objective factors and subjective factors,which should be treated with a comprehensive approach.