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目的探讨剖宫产术后再次妊娠分娩方式的选择。方法随机抽取2008-01～2009-09收治剖宫产术后再次妊娠孕妇156例,对其分娩方式、分娩结局及医疗费用进行回顾性分析评价。结果 156例剖宫产术后再次妊娠者,行再次剖宫产(RCS)125例(其中择期剖宫产112例,阴道试产改行剖宫产13例),占80.13%;阴道试产(TOL)44例,占28.21%,试产成功率为70.45%;阴道分娩(VBAC)31例,占19.87%。RCS组较VBAC组出血量大,分别为(175.7±4.0)ml和(85.5±8.5)ml,平均住院天数RCS组较VBAC组相对较长,分别为(8.20±1.58)d和(3.20±0.42)d,医疗费用RCS组较VBAC组为高。结论有剖宫产史再次妊娠者,不一定选择剖宫产作为绝对指征,如无试产禁忌者可在严密监护下先行阴道试产。
Objective To explore the choice of delivery mode after cesarean section. Methods One hundred and fifty-five pregnant women were selected randomly from January 2008 to September 2009 after cesarean section, and their delivery methods, delivery outcomes and medical costs were analyzed retrospectively. Results Of the 156 patients who were re-pregnant after cesarean section, 125 cases were re-cesarean (RCS) (112 cases were elective cesarean section and 13 cases were cesarean section under vaginal trial), 80.13% TOL) 44 cases, accounting for 28.21%, trial success rate was 70.45%; vaginal delivery (VBAC) in 31 cases, accounting for 19.87%. The mean length of stay in the RCS group was (175.7 ± 4.0) ml and (85.5 ± 8.5) ml, respectively, and was significantly longer in the RCS group than in the VBAC group (8.20 ± 1.58 and 3.20 ± 0.42, respectively d, medical expenses RCS group is higher than VBAC group. Conclusion Cesarean section pregnancy again, not necessarily choose cesarean section as an absolute indication, such as no trial of contraindications in the first vaginal trial under close supervision.