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目的研究对瘢痕子宫再次妊娠产妇采取阴道试产的临床疗效及安全性,为选择合理的分娩方式提供参考。方法采取随机双向对照的设计方法,将78例瘢痕子宫再次妊娠孕产妇分成阴道试产组40例和剖宫产组38例,比较两组产后出血量、新生儿Apgar评分、新生儿体质量、住院时间等分娩生产情况、妊娠结局情况,并评价安全性。结果 40例阴道试产分娩孕产妇32例(80.0%)试产成功,8例因宫缩乏力、宫内窘迫、羊水污染等试产失败。阴道试产组平均出血量、平均住院时间均少于剖宫产组(P<0.05),不过两组在新生儿Apgar评分、新生儿体质量方面比较差异未见统计学意义(P>0.05)。结论 (1)瘢痕子宫再次妊娠选择剖宫产成功率相对较低,安全风险较大;(2)建议在充分掌握阴道试产的条件下,选择阴道分娩方式以提高分娩成功率,降低并发症发生率,提高妊娠结局。
Objective To study the clinical efficacy and safety of taking vaginal trial of pregnant women with uterine scar pregnancy again, so as to provide a reference for choosing a reasonable mode of delivery. Methods A randomized two-way controlled design was adopted. Seventy-eight pregnant women with uterine scar pregnancy were divided into vaginal trial group (40 cases) and cesarean section group (38 cases). The postpartum hemorrhage, neonatal Apgar score, neonatal body weight, Hospitalization time delivery and other production conditions, pregnancy outcomes, and evaluate the safety. Results 32 cases (80.0%) of vaginal delivery and vaginal delivery were successful in trial production and 8 cases failed in trial production due to uterine inertia, intrauterine distress and amniotic fluid contamination. The average amount of bleeding and the average length of hospital stay in the vaginal trial group were less than those in the cesarean section group (P <0.05). However, there was no significant difference between the two groups in neonatal Apgar score and neonatal body weight (P> 0.05) . Conclusions (1) The success rate of cesarean pregnancy after scar pregnancy is relatively low and the safety risk is relatively high. (2) It is suggested that vaginal delivery should be selected to improve the success rate of delivery and reduce the complications Incidence, improve pregnancy outcomes.