剖宫产后再次妊娠分娩方式的临床分析

目的探讨剖宫产术后再次妊娠分娩方式的最佳选择。方法对167例有剖宫产史的孕妇再次妊娠后其分娩方式、分娩结局及母婴并发症等临床资料进行回顾性分析,将其中再次剖宫产44例与随机抽取同期首次剖宫产50例进行对照,将其中剖宫产后阴道分娩123例与随机抽取同期无剖宫产史孕妇阴道分娩120例进行对照。结果 167例有剖宫产史的孕妇再次妊娠后有123例阴道试产成功,成功率为73.7%;前次剖宫产后再次妊娠阴道分娩组与无剖宫产史阴道分娩组产程、产后出血、新生儿窒息等方面比较比较差异无统计学意义(P>0.05);再次剖宫产44例,占26.3%;再次剖宫产与首次剖宫产两组术中出血量、平均手术时间、切口感染率比较差异有统计学意义(P<0.05);新生儿窒息窒息率比较差异无统计学意义(P>0.05)。结论剖宫产术后再次妊娠并非是剖宫产绝对指征,只要在医务人员严密监护下,阴道分娩是安全可行,有效的降低剖宫产率。

Clinical Analysis of Mode of Delivery about Cesarean Section after Subsequent Pregnancy

Objective Subsequent pregnancy after cesarean section the best mode of delivery.Methods 167 patients with history of cesarean section in pregnant women after their pregnancy, delivery mode again, birth outcomes and maternal complications such as clinical data were retrospectively analyzed 44 cases of cesarean section will be one again with the same period for the first time cesarean section randomly selected 50 patients were compared, to which 123 cases of vaginal delivery after cesarean section with no history of cesarean section were randomly selected pregnant women over the same period 120 cases of vaginal delivery were compared.Results 167 cases of pregnant women with history of cesarean section after a subsequent pregnancy, there were 123 cases of vaginal successful pilot, the success rate was 73.7%; pregnant again after previous cesarean section group and vaginal delivery vaginal delivery group without history of cesarean birth process, postpartum hemorrhage, neonatal asphyxia, etc. There was no significant difference （P〉 0.05）; again cesarean section in 44 cases, 26.3%; again cesarean section cesarean section and for the first time two sets of blood loss, mean operative time, the wound infection rate difference was statistically significant （P〈0.05）; neonatal asphyxia asphyxia difference was not statistically significant （P〉0.05）.Conelusions Subsequent pregnancy after cesarean section is not an absolute indication for cesarean section, as long as the medical intensive care, vaginal delivery is safe and feasible and effective to reduce the cesarean section rate.