瘢痕子宫助产策略研究进展

瘢痕子宫是指剖宫产术或子宫肌瘤剔除术、子宫穿孔或破裂修复术、子宫成形术等妇产科手术后的子宫，其中剖宫产术是瘢痕子宫产生的最主要原因。目前，随着临床剖宫产率的不断增加和计生政策的改变，瘢痕子宫再次妊娠的发生率逐渐升高。由于瘢痕子宫再次妊娠发生母儿并发症的风险均增加，分娩时不论是行选择性剖宫产还是阴道试产，都可能出现严重的临床并发症，因此正确处理瘢痕子宫再次分娩的问题，成为围生医学亟待研究的课题之一。本文综述了瘢痕子宫再次妊娠分娩方式选择、阴道分娩现状和产程管理等助产策略，以期为医护人员选择合适的再分娩方式提供依据，不断提高产科质量。

Research Progress on the Delivery Mode of Cicatricial Uterus

Cicatricial uterus refers to the uterus after cesarean section or myomectomy, repair of perforation or rupture, hysteroplasty and other gynecologic operations, in which cesarean section is the main reason of the cicatricial uterus. In recent years, because of the high rate of cesarean section and changes in the policy of family planning, the number of pregnant women with a prior cesarean delivery has increased year by year. However, the management of the pregnancy in cicatricial uterus is always a challenge subject of obstetrics because of the high risk of the serious maternal and perinatal complications. It is one of the most urgent and complicated problems for an obstetrist how to treat correctly the delivery model of the pregnancy in cicatricial uterus. We review the obstetrical strategy in the treatment of the second pregnancy of cicatricial uterus, including the delivery model, the dications of vaginal delivery, and labor management, to provide practical guidelines of delivery model and improve the quality of obstetrics.