瘢痕子宫再次妊娠患者阴道分娩的安全性研究

目的探讨瘢痕子宫再次妊娠患者阴道分娩的安全性。方法57例瘢痕子宫再次妊娠患者,随机分为对照组(30例)和观察组(27例)。对照组采用剖宫产分娩,观察组采用阴道试产分娩。比较两组住院时间、新生儿体质量、出血量、Apgar评分及产褥感染、新生儿窒息、子宫破裂发生情况。结果两组新生儿体质量、Apgar评分比较差异无统计学意义(P>0.05);观察组出血量(159.5±19.3)ml少于对照组的(278.5±41.6)ml,住院时间(4.5±1.9)d短于对照组的(7.5±1.3)d,差异具有统计学意义(P<0.05)。两组患者均未发生子宫破裂。观察组产褥感染、新生儿窒息发生率分别为0、3.70%,均低于对照组的13.33%、23.33%,差异具有统计学意义(P<0.05)。结论阴道分娩用于瘢痕子宫再次妊娠患者中具有较高的安全性,能改善妊娠结局,值得推广应用。

Study on safety of vaginal delivery in second pregnancy patients with scarred uterus

Objective To discuss the safety of vaginal delivery in second pregnancy patients with scarred uterus.Methods A total of 57 cases of second pregnancy patients with scarred uterus were randomly divided into control group(30 cases)and observation group(27 cases).The control group received cesarean delivery,and the observation group received vaginal trial delivery.The hospitalization time,neonatal body mass,amount of hemorrhage,Apgar score and occurrence of puerperal infection,neonatal asphyxia and uterine rupture were compared between the two groups.Results There was no statistically significant difference in neonatal body mass and Apgar score between the two groups(P>0.05).The amount of hemorrhage(159.5±19.3)ml in the observation group was less than(278.5±41.6)ml in the control group,and hospitalization time(4.5±1.9)d was shorter than(7.5±1.3)d in the control group,and the difference was statistically significant(P<0.05).There was no uterine rupture in both groups.The incidence of puerperal infection,neonatal asphyxia were 0 and 3.70% respectively in the observation group,which were lower than 13.33% and 23.33% in the control group,and their difference was statistically significant(P<0.05).Conclusion Vaginal delivery shows high safety in second pregnancy patients with scarred uterus,and it can improve pregnancy outcome.It is worthy of promotion and application.