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目的研究剖宫产术后再次妊娠患者分娩方式的选择,为临床提供依据。方法选取2014年7月至2015年7月剖宫产术后再次妊娠妇女资料100例进行回顾性分析,将其依照妊娠合并高危因素,包括子宫切口异常以及胎盘位置异常等分为高危瘢痕子宫妊娠组以及普通瘢痕子宫妊娠组,将普通瘢痕子宫妊娠组患者依照分娩方式分为再次剖宫产组以及经阴道分娩组,对于两组患者的分娩结局、医疗费用和母婴并发症情况进行总结和比较,将结果进行统计学分析。结果 100例患者中高危瘢痕子宫妊娠组患者20例,普通瘢痕子宫妊娠组患者80例,其中经阴道分娩组患者10例,再次剖宫产组患者70例,再次剖宫产组患者中由于社会因素采取手术者30例。经阴道分娩组患者的住院费用、出血量以及住院时间显著低于再次剖宫产组患者,差异有统计学意义(P<0.05);再次剖宫产组新生儿由于RDS转NICU概率、住院时间以及住院费用显著高于经阴道分娩组患者,差异有统计学意义(P<0.05)。结论针对剖宫产术后再次妊娠患者孕期需要详尽各项检查,将胎盘位置异常、子宫切口异常等高危因素进行筛选,选取最恰当的阴道试产方式,减少由于社会因素引起的再次剖宫产率。
Objective To study the choice of mode of delivery in pregnant women after cesarean section and to provide evidence for clinical practice. Methods A retrospective analysis of 100 pregnant women after cesarean section from July 2014 to July 2015 was conducted. According to the high risk factors of pregnancy, including abnormal uterine incision and abnormal placenta, the patients were divided into high-risk scar uterine pregnancy Group and normal scar uterine pregnancy group, the average scar pregnancy group patients according to mode of delivery is divided into cesarean section group and vaginal delivery group, for the two groups of childbirth outcomes, medical costs and maternal and child complications were summarized and The results were compared statistically. Results 100 cases of high-risk scar pregnancy in patients with uterine pregnancy in 20 cases, 80 cases of ordinary scar pregnancy in patients, including 10 cases of vaginal delivery group, again in the cesarean section group of 70 patients in the second cesarean section patients due to social 30 factors to take surgery. The costs of hospitalization, bleeding and hospital stay in vaginal delivery group were significantly lower than those in the second cesarean section group (P <0.05). The incidence of newborns in the second cesarean section group was significantly lower than that of the second cesarean section group And hospitalization costs were significantly higher than those in vaginal delivery group, the difference was statistically significant (P <0.05). Conclusions For pregnancy after cesarean section, pregnant women need detailed examination during pregnancy. The screening of high risk factors such as abnormal placental position and abnormal uterine incision will select the most appropriate vaginal trial production method to reduce the recurrence of cesarean section due to social factors rate.