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目的探讨瘢痕子宫再次剖宫产与非瘢痕子宫剖宫产的安全性。方法选取2014年10月-2015年10月医院收治的剖宫产妊娠女性118例,依子宫及分娩情况分为试验组(瘢痕子宫再次妊娠产妇)57例与对照组(非瘢痕子宫初次妊娠产妇)61例。全部患者入院后均以剖宫产分娩,回顾性分析两组患者分娩期间的临床资料,比较其手术指标及术后情况,分析其剖宫产原因。结果先兆子宫破裂试验组7例(12.28%),对照组2例(3.28%),差异有统计学意义(P=0.025)。试验组产妇较对照组产妇剖宫产耗时更长,产中、产后出血量更大,产后恶露时间更久,差异有统计学意义(P<0.05);新生儿Apgar评分对照组≥7分者60例,试验组56例,2组比较差异无统计学意义(P>0.05)。社会、个人因素是2组产妇的主要剖宫产指征,2组比较差异无统计学意义(P>0.05)。婴儿胎位异常指征、胎儿窘迫指征及产程进展异常指征2组比较差异有统计学意义(P<0.05)。结论与非瘢痕子宫剖宫产相比,瘢痕子宫再次剖宫产的风险较高,故临床确定瘢痕子宫再次妊娠产妇分娩方式时需综合考虑多方因素,谨慎选择最适宜的分娩方式,以确保母婴安全。
Objective To investigate the safety of cesarean section with cesarean section and non-scar case in cesarean section. Methods A total of 118 pregnant women with cesarean section were selected from October 2014 to October 2015 in our hospital. According to the status of uterus and childbirth, 57 pregnant women with scar uterine recurrence were divided into control group (57 cases) 61 cases. All patients were delivered by cesarean section after delivery. The clinical data of the two groups during delivery were retrospectively analyzed. The operative indexes and postoperative conditions were compared, and the causes of cesarean section were analyzed. Results There were 7 cases (12.28%) in the test group of uterine rupture and 2 cases (3.28%) in the control group, the difference was statistically significant (P = 0.025). The test group maternal cesarean section longer than the control group maternal, mid-delivery, postpartum hemorrhage greater postpartum lochia longer, the difference was statistically significant (P <0.05); neonatal Apgar score control group ≥ 7 points 60 cases, 56 cases in the experimental group, there was no significant difference between the two groups (P> 0.05). Social and personal factors were the main indications of cesarean section in the two groups, there was no significant difference between the two groups (P> 0.05). Infantile abnormal fetal position indications, fetal distress indications and abnormal progress of labor indications showed significant difference between the two groups (P <0.05). Conclusion Compared with non-scarring uterine cesarean section, scarring uterine cesarean section again a higher risk, so the clinical determination of uterine scar re-pregnancy maternal delivery mode must take into account multi-factor, carefully choose the most appropriate mode of delivery to ensure that the mother Baby safety.