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目的探讨瘢痕子宫患者再次妊娠行阴道试产的可行性以及影响因素。方法选取2015年1月至2017年1月于广东省佛山市顺德区妇幼保健院产科分娩的80例瘢痕子宫再次妊娠产妇作为研究对象。采用随机数字表法将患者分为观察组与对照组,对照组40例产妇直接采取剖宫产手术分娩,观察组40例产妇则首先进行阴道分娩试产,比较两组产妇的分娩结局以及围产期并发症发生情况。结果观察组与对照组产妇新生儿Apgar评分比较差异无统计学意义(P>0.05);观察组产妇产时出血量、住院时间均明显小于对照组,围产期并发症发生率明显低于对照组,差异均有统计学意义(均P<0.05);而针对行阴道试产的因素分析认为,孕期、新生儿体重、宫颈条件、试产时间、产妇年龄与体重指数(BMI)均是影响阴道试产成功的主要因素。结论瘢痕子宫患者再次妊娠行引导试产并不会对新生儿质量以及母婴生命安全产生不良影响,可有效降低产时出血量、围产期并发症发生风险,但应结合相关影响因素谨慎选择分娩方式,保证母婴生命安全及新生儿质量。
Objective To investigate the feasibility and influencing factors of vaginal trial of pregnant women with uterine scar again. METHODS: From January 2015 to January 2017, 80 pregnant women with scar uterine uterus who were delivered from obstetrics and gynecology department of Shunde District Maternal and Child Health Hospital of Foshan City, Guangdong Province, were selected as research objects. The patients were divided into observation group and control group by random number table method. 40 maternal women in the control group were delivered by cesarean section directly. 40 maternal women in the observation group were given vaginal delivery trial at first. The delivery outcomes of the two groups were compared. Occurrence of complications during delivery. Results There was no significant difference in Apgar score between the observation group and the control group (P> 0.05). The bleeding time and hospitalization time in the observation group were significantly less than those in the control group, and the incidence of perinatal complications was significantly lower than that in the control group (P <0.05). However, the analysis of the factors of vaginal trial showed that body weight, cervical condition, trial time, maternal age and body mass index (BMI) Vaginal trial production affect the success of the main factors. Conclusion Reproductive pregnancy in pregnant women with uterine scar pregnancy will not adversely affect the quality of neonates and the safety of mother and infant. It can effectively reduce the amount of bleeding during birth and the risk of perinatal complications, but should be carefully selected according to the relevant factors Mode of delivery, to ensure the safety of mothers and infants and neonatal quality.