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目的:探讨瘢痕子宫再次妊娠合理的分娩方式。方法:回顾性分析2013年1月至2013年12月瘢痕子宫产妇中阴道分娩及再次剖宫产的母婴结局。结果:150例瘢痕子宫产妇中再次剖宫产112例,阴道试产38例,试产率25.3%,试产成功31例,成功率81.58%;两组分娩方式新生儿情况比较,Apgar评分无明显差异。产妇情况比较,再次剖宫产组分娩期并发症,出血量、产褥热、住院天数、住院费用等明显高于阴道分娩组(P<0.05)。结论:瘢痕子宫再次妊娠分娩并非是剖宫产绝对指征,阴道分娩与剖宫产相比利多弊少,只要严密观察产程,正确处理,阴道试产是安全可行的,同时也降低了剖宫产率,减少后期妇产科相关手术风险及并发症。
Objective: To investigate the reasonable mode of delivery for scar pregnancy again. Methods: The maternal and infant outcomes of vaginal delivery and cesarean section were retrospectively analyzed from January 2013 to December 2013 in scarring uterus. Results: Among 150 cases of scarring uterus, 112 cases of cesarean section, 38 cases of vaginal trial, the trial yield of 25.3%, 31 cases of trial success, the success rate of 81.58%; two groups of delivery mode neonatal comparison, Apgar score Significant differences. Compared with the maternal condition, the cesarean delivery rate, bleeding volume, puerperal fever, hospitalization days and hospitalization costs were significantly higher than those of the vaginal delivery group (P <0.05). Conclusion: Cesarean scar pregnancy again is not an absolute indication of cesarean delivery, vaginal delivery compared with cesarean delivery more advantages and disadvantages, as long as the strict observation of labor, correct treatment, vaginal trial is safe and feasible, but also reduce the cesarean section Yield, reduce the risk of obstetrics and gynecology-related surgery and complications.