剖宫产术后再次妊娠分娩方式选择的临床分析

目的:探讨剖宫产术后再次妊娠孕妇最佳分娩方式的选择。方法:对我院2007年8月～2011年8月期间收冶的剖宫产术后再次妊娠孕妇168例的临床资料进行回顾性分析。结果:168例剖宫产后再次妊娠孕妇中,102例阴道试产,其中78例经阴道顺产分娩,成功率76.5%,90例孕妇再次剖宫产术。阴道分娩与再次剖宫产在新生儿窒息、新生儿感染、新生儿颅内出血间比较差异无显著性,无统计学意义(P>0.05),再次剖宫产孕妇在产后出血、产褥感染、子宫切除及平均住院时间等方面均高于阴道分娩产妇,二者比较差异有显著性,有统计学意义(P<0.05)。结论:剖宫产术后再次妊娠的孕妇选择分娩方式时,经阴道顺产分娩方式不是绝对禁忌症,只要严格掌握适应症,符合阴道顺产分娩条件者在严密监测下行阴道分娩是安全有效的。

The clinical analysis of selected methods of secondary pregnancy and delivery after cesarean section

Objective:To investigate the selection of the best delivery methods of secondary pregnancy and delivery after cesarean section.Methods:To retrospectively analyze the clinical data in our hospital of 168 paradigms of gravidas of secondary pregnancy after cesarean section from August,2007 to August 2011.Result:In these gravidas,there are 78 paradigms of gravidas spontaneous delivery and the achievement ratio is 76.5%;90 paradigms repeat cesarean section in 102 paradigms of gravidas of vaginal Labor trials.There are no significantly difference between Vaginal delivery and Repeated cesarean section in asphyxia of newborn,infection of newborn and intracranial hemorrhage of newborn(P>0.05).The Postpartum Hemorrhage,puerperal infection,hysterectomy and the average of hospital stay of Repeated cesarean section will be larger,higher and longer than Vaginal delivery.There are significantly difference between them,with statistical significance(P<0.05).Conclusion:When the gravidas of secondary pregnancy select delivery ways,the way of per vagina is not absolute contraindication.As long as rigorously handle indication and is consistent with Vagina spontaneous delivery,Vaginal delivery is safe and effective under the rigorously surveillance.