剖宫产术后再次妊娠172例临床分析

目的 探讨剖宫产术后再次妊娠分娩方式的选择,以期减少分娩并发症.方法 选择民航总医院妇产科2005年1月至2008年12月住院的剖宫产术后再次妊娠孕妇172例,对其分娩方式、分娩结局进行回顾性分析.将其中剖宫产术后阴道分娩48例与同期非剖宫产术后子宫阴道分娩48例进行对照分析,再次剖宫产124例与随机抽取同期首次剖宫产124例进行对照分析.结果 172例剖宫产术后再次妊娠孕妇中,有54例阴道试产,48例试产成功,成功率88.89%,瘢痕子宫与正常子宫阴道分娩产后出血差异无统计学意义;再次剖宫产124例,手术产率72.09%,再次剖宫产与首次剖宫产产后出血量差异有统计学意义（265±14）ml比（201±12）ml,P＜0.05].结论 剖宫产术后再次妊娠的孕妇在一定条件下可阴道分娩,应给予试产机会,瘢痕子宫并非再次剖宫产的绝对指征.

Analysis of 172 cases of re-pregnancy after caesarean section

Objective To analyze the delivery ways of the re-pregnant women after caesarean section. Methods The mode of delivery and birth outcome of 172 cases re-pregnancy after caesarean section from Jan. 2005 to Dec. 2008 were retrospectively analyzed. 48 cases of vaginal delivery after cesarean section were compared with 48 cases of non-vaginal birth after cesarean section during the same period. 124 cases of re-cesarean section were compared with 124 random case of cesarean section for the first time during the same period. Results Among 172 cases , 54 cases had vaginal labor in whom 48 cases succeeded. The success rate was 88. 89%. There was no significant difference in postpartum hemorrhage scar uterus and no-scar uterus. There were 124 cases of re-caesarean section. There was a significant difference in postpartum hemorrhage re-caesarean section and cesarean section for the first time (265 ±14)ml vs (201 ±12)ml, P<0.05]. Conclusions Scar uterus can be applied to vaginal delivery. Caesarea section history is not the definite indication of caesarean birth.