689例瘢痕子宫再次妊娠分娩方式的临床研究

目的:探讨瘢痕子宫再次妊娠分娩方式的选择和可行性,降低剖宫产率。方法:对本院2012年1-12月瘢痕子宫再次妊娠的689例产妇临床资料进行回顾性分析,按分娩方式的不同分为再次剖宫产组538例,经阴道分娩组151例,并选取同期首次剖宫产的1398例与再次剖宫产的538例进行分析比较。结果:再次剖宫产组和阴道分娩组在新生儿Apgar评分、体重、感染方面比较差异均无统计学意义(P0.05)。阴道分娩组的产妇出血量、发热例数、平均住院时间、费用均小于再次剖宫产组,两组比较差异均有统计学意义(P0.05)。再次剖宫产组在开剖至胎儿娩出时间、产后出血量、严重粘连率等方面均大于首次剖宫产组,两组比较差异均有统计学意义(P0.05)。结论:瘢痕子宫再次妊娠分娩方式的选择,应针对产妇的具体情况,要从多方面综合考虑评估。

The Clinical Research on the Model of Uterine Scar Pregnancy Based on 689 Cases

Objective：To explore the option and feasibility of the uterine scar pregnancy again and reduce the rate of cesarean delivery. Method：689 cases of puerperal clinical patients in the hospital from January to December in 2012 were analyzed. According to the pregnancy type,cesarean section again included 538 cases and vaginal delivery included 151 cases. And 538 cases of cesarean section again were selected by compared 1398 cases of cesarean delivery for the first time. Result：There was no statistically significant difference between the cesarean sections again group and the vaginal delivery group at apgar score,weight and infection（P〉0.05）. The maternal blood loss,fever cases,the average length of hospital stay and cost of the vaginal delivery group were significantly smaller than the cesarean sections again group（P〈0.05）. The open cutting to fetal childbirth time,postpartum blood loss,severe adhesion rate of the cesarean sections again group were significantly bigger than cesarean sections for the first time group（P〈0.05）. Conclusion：It has to master the indications of uterine scar pregnancy again vaginal delivery,and keep to closely watch over the situation that meets the conditions for the trial production.