影响无痛瘢痕子宫阴道试分娩结局的危险因素分析

目的 分析影响无痛瘢痕子宫阴道试分娩结局的危险因素.方法 选取2017年6月至2018年6月河北省唐山市妇幼保健院收治的238例瘢痕子宫阴道试分娩产妇作为研究对象,进行回顾性分析.根据阴道试分娩结局分为成功组(n=147)和失败组(n=91).采用Logistic回归分析探究产妇临床资料对发生不良妊娠结局的影响.结果 ...

Analysis on risk factors of the vaginal delivery outcome in patients with painless scarred uterus pregnancy

Objective To analyze the risk factors of the vaginal delivery outcome in patients with painless scarred uterus pregnancy.Methods A total of 238 patients with scar uterus trying to vaginal delivery in Tangshan Maternal and Child Health Hospital of Hebei Province from June 2017 to June 2018 were selected as the research subjects and analyzed retrospectively.According to the outcome of vaginal trial delivery,they were divided into successful group(n=147)and failure group(n=91).Logistic regression analysis was used to explore the effect of maternal clinical data on adverse pregnancy outcomes.Results There were statistically significant differences in age,educational level,BMI,lower uterine thickness and hospital anxiety and depression scale(HADS)scores between the two groups(P<0.05).There were no significant differences in gestational weeks,interval between last cesarean section,in-labor hospitalization,regular pregnancy examination and combined gestational diabetes/hypertension(P>0.05).Logistic regression analysis showed that age≥35 years old,BMI≥30kg/m 2,lower uterine thickness<3.9mm and HADS score were independent risk factors for the outcome of vaginal trial delivery with scar uterus.The incidence of uterine rupture,puerperal infection,postpartum hemorrhage,fetal distress and neonatal asphyxia in the successful group were significantly lower than those in the failure group,with statistical significance(P<0.05).Conclusions Age,BMI,lower uterine segment and depression are the important factors for the failure of vaginal trial delivery with scar uterine pregnancy,which are easy to induce the occurrence of adverse pregnancy outcomes.Clinical intervention should be given from diet,exercise and psychological counseling according to the risk factors,so as to improve the outcome of vaginal trial delivery and promote the prognosis.