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目的:了解剖宫产术后再次妊娠时分娩方式的选择情况。方法:选取乐清市第二人民医院分娩的有剖宫产手术史的110位孕妇,对她们再次妊娠的分娩方式和分娩结局进行分析。按照孕妇的意愿有62例孕妇选择再次剖宫产,有48例孕妇选择经阴道分娩。从住院时间、出血量、产褥感染、新生儿感染、新生儿窒息等指标比较两种分娩方式对母婴的影响。结果:对产妇影响:①出血量方面:选择剖宫产者出血量为(290.69±5.63)ml,而经阴道分娩者为(162.40±8.30)ml,两种方法相比有统计学差异(P<0.05);②住院时间:选择剖宫产孕妇的住院时间为(7.32±1.04)天,而经阴道分娩者为(3.14±0.89)天,两种方法相比有统计学差异(P<0.05);③产褥感染:选择剖宫产的孕妇发生感染8例,占12.9%(8/62),而经阴道分娩感染1例,占2.08%(1/48),两种方法相比有统计学差异(P<0.05)。对婴儿影响:①新生儿感染:选择剖宫产的孕妇发生新生儿感染3例,占4.84%,而经阴道分娩发生新生儿感染1例,占2.08%,两种方法相比无统计学差异(P>0.05);②新生儿窒息:剖宫产的孕妇中发生新生儿窒息2例,占3.23%,而经阴道分娩发生1例,占2.08%,两种方法相比无统计学差异(P>0.05)。结论:具有剖宫产手术史的孕妇在选择妊娠方式时,可以考虑采用经阴道分娩。
Objective: To understand the choice of mode of delivery during pregnancy after cesarean section. Methods: A total of 110 pregnant women with history of cesarean delivery in No.2 People’s Hospital of Yueqing City were enrolled in this study. Their delivery mode and delivery outcome were analyzed again. In accordance with the wishes of pregnant women, 62 cases of pregnant women choose to cesarean section again, 48 cases of pregnant women choose vaginal delivery. The effects of two modes of delivery on maternal and infant were compared from hospitalization time, blood loss, puerperal infection, neonatal infection and neonatal asphyxia. Results: The impact on mothers: ① bleeding: the choice of cesarean section bleeding was (290.69 ± 5.63) ml, while vaginal delivery was (162.40 ± 8.30) ml, the two methods were statistically significant (P <0.05). ②The length of hospital stay was (7.32 ± 1.04) days for cesarean section and (3.14 ± 0.89) days for vaginal delivery, there was a significant difference between the two methods (P <0.05 ); Puerperal infection: 8 cases of pregnant women choose cesarean section, accounting for 12.9% (8/62), while 1 case of vaginal delivery infection, accounting for 2.08% (1/48), compared with the two methods Statistical difference (P <0.05). Impact on infants: ① neonatal infection: Neonatal infection occurred in 3 pregnant women who chose cesarean section, accounting for 4.84%, while 1 case of neonatal infection by vaginal delivery, accounting for 2.08%, there was no significant difference between the two methods (P0.05). ② Neonatal Asphyxia: Neonatal asphyxia in cesarean section occurred in 2 cases (3.23%) and in vaginal delivery in 1 case (2.08%). There was no significant difference between the two methods P> 0.05). CONCLUSIONS: Pregnant women with a history of cesarean delivery may consider transvaginal delivery when choosing a pregnancy pattern.