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目的探讨瘢痕子宫再次妊娠行阴道分娩的可行性,为阴道分娩的推广和使用提供指导。方法选取2012年12月至2013年12月在沈阳医学院附属中心医院分娩的140例瘢痕子宫再次妊娠产妇为研究对象,按随机数字表法分为观察组和对照组,每组70例。观察组采取阴道分娩,对照组采取剖宫产分娩。比较两组患者的分娩结果、分娩时间、分娩过程中的出血量、新生儿Apgar评分、住院时间、并发症及分娩满意度。结果观察组的阴道分娩成功率为88.6%,观察组患者的分娩时间、分娩出血量、新生儿Apgar评分、住院时间等均优于对照组,差异均有统计学意义(均P<0.05);两组均未出现严重并发症,仅部分产妇出现轻微的并发症,观察组患者的并发症发生率为7.1%,明显低于对照组的21.4%,差异有统计学意义(P<0.05)。结论对于符合条件的瘢痕子宫再次妊娠产妇行阴道分娩成功率,并能显著缩短分娩时间,改善新生儿出生情况,减少并发症的发生,因此阴道分娩用于瘢痕子宫再次妊娠安全、可行。
Objective To investigate the feasibility of vaginal delivery of scar pregnancy after uterine pregnancy and provide guidance for the promotion and use of vaginal delivery. Methods From December 2012 to December 2013, 140 pregnant women with scar pregnancy and uterus delivered from Central Hospital of Shenyang Medical College were divided into observation group and control group according to the random number table method, with 70 cases in each group. The observation group adopted vaginal delivery, while the control group adopted cesarean delivery. Results of delivery, delivery time, bleeding during childbirth, neonatal Apgar score, length of hospital stay, complications and delivery satisfaction were compared between the two groups. Results The success rate of vaginal delivery in observation group was 88.6%. The delivery time, delivery bleeding, Apgar score and hospital stay in observation group were better than those in control group (all P <0.05). No serious complication occurred in both groups, only some of the women had mild complications. The complication rate in the observation group was 7.1%, which was significantly lower than that in the control group (21.4%, P <0.05). Conclusions The success rate of vaginal delivery of the pregnant women with scar pregnancy and uterine scar pregnancy can significantly shorten the delivery time, improve the birth condition and reduce the incidence of complications. Therefore, it is safe and feasible for vaginal delivery to be used again for the uterine scar pregnancy.