瘢痕子宫再次妊娠分娩方式及妊娠结局的探讨

目的探讨瘢痕子宫再次妊娠分娩的分娩方式及妊娠结局等相关因素。方法回顾性分析本院2014年1月1日~3月31日分娩的38例瘢痕子宫再次妊娠。结果阴道试产7例,阴道分娩5例,阴道分娩率占13.16%,阴道试产成功率达71.43%;再次剖宫产33例,再次剖宫产率为86.84%,占同期剖宫产总数的18.86%。无一例子宫破裂,新生儿结局良好,1例凶险型前置胎盘胎盘植入剖宫产术中大出血并切除子宫。结论瘢痕子宫再次妊娠剖宫产分娩率远远高于阴道分娩率,高于同期剖宫产率;严格控制第一次剖宫产指征,提高产科医生的技术水平,加强孕产期监护,医患配合的条件下,可在一定程度上降低剖宫产率,减少严重并发症。

The mode of delivery and pregnancy outcome of secondary pregnancy of scar uterus

Objective To explore the mode of delivery and pregnancy outcome of secondary pregnancy of scar uterus.Methods Clinical data of 38 cases of secondary pregnant women after cesarean section in our hospital from January 1to March 31 2014 was retrospectively analyzed. Results There were 7 cases of vaginal delivery in 38 cases of pregnant women with pregnancy after cesarean section,which was successful in 5 cases（71.43%）;33 cases of pregnant women were cesarean section again,operation rate was 86.84%;There was no case of uterine rupture in 38 cases secondary pregnant women after cesarean section,neonatal outcome was good,one case of dangerous type previa placenta and placenta accreta was fierce bleeding and hysterectomy during cesarean section. Conclusion The rate of cesarean delivery is much higher than the rate of vaginal delivery and is also higher than the rate of cesarean delivery in the same period.We will reduce the rate of cesarean delivery and serious complications throng strict controlling of the first cesarean section,improving skills,strengthening maternity care.