引用本文:张姝静.瘢痕子宫再次妊娠产妇阴道分娩的结局及影响因素分析[J].中国临床新医学,2019,12(5):550-553.
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瘢痕子宫再次妊娠产妇阴道分娩的结局及影响因素分析
张姝静
415000 湖南,常德市职业技术学院附属第一医院(常德市第三人民医院)妇产科
摘要:
[摘要] 目的 分析瘢痕子宫再次妊娠产妇阴道分娩的结局及影响因素。方法 回顾性分析2014-03~2016-08在该院接受分娩的100例瘢痕子宫产妇的临床资料,根据其分娩方式分为经阴道分娩组42例和剖宫产组58例。观察比较两组产妇分娩前后血流动力学的变化和新生儿Apgar评分,分析影响瘢痕子宫经阴道分娩的因素。结果 两组产妇分娩前的血流动力学指标无明显差异,分娩后经阴道分娩组的血红蛋白(Hb)、血小板(PLT)水平高于剖宫产组(P<0.05),而两组的脉搏血氧饱和度(SpO2)、呼气末二氧化碳分压(PETCO2)和中心静脉压(CVP)水平差异无统计学意义(P>0.05);两组新生儿吸入性肺炎、颅内出血发生率和出生后Apgar评分差异均无统计学意义(P>0.05);经阴道分娩组分娩后24 h内出血量为(234.45±15.42)ml,明显低于剖宫产组的(385.62±14.56)ml,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,距离上次剖宫产的时间、胎儿重量、产前体重指数(BMI)和阴道分娩史是影响瘢痕子宫产妇经阴道分娩的危险因素(P<0.05)。结论 瘢痕子宫产妇经阴道分娩的安全性较高,且预后较好。距上次剖宫产时间、胎儿重量、产前BMI和阴道分娩史是影响瘢痕子宫产妇经阴道分娩的危险因素。
关键词:  瘢痕子宫  妊娠  阴道分娩  Apgar评分
DOI:10.3969/j.issn.1674-3806.2019.05.21
分类号:R 714
基金项目:
Analysis of pregnancy outcome and influencing factors of vaginal delivery of scar uterus
ZHANG Shu-jing
Department of Obstetrics and Gynecology, the First Affiliated Hospital of Changde Vocational Technical College(the Third People′s Hospital of Changde City), Hunan 415000, China
Abstract:
[Abstract] Objective To analyze the pregnancy outcome and the influencing factors of vaginal delivery of scar uterus. Methods The clinical data of the pregnant women with scar uterus treated in our hospital from March 2014 to August 2016 were retrospectively analyzed. According to the modes of delivery, the patients were divided into the vaginal delivery group and the cesarean section group. The changes of hemodynamics and neonatal Apgar score were observed in the two groups before and after delivery, and the influencing factors affecting the vaginal delivery of scar uterus were analyzed. Results There were no significant differences in hemodynamic parameters before delivery. After delivery, the levels of hemoglobin(Hb) and platelet(PLT) in the vaginal delivery group were higher than those in the cesarean section group(P<0.05), while there were no differences in the levels of SpO2, PETCO2 and CVP between the two groups(P>0.05). The incidence rates of aspiration pneumonia, intracranial hemorrhage and Apgar scores after birth showed no significant differences between the two groups(P>0.05). The 24- hour bleeding volume of the vaginal delivery group[(234.45±15.42)ml] after delivery was significantly less than that of the cesarean section group[(385.62±14.56)ml](P<0.05). Logistic regression analysis showed that the last cesarean section time, fetal weight, prepregnance BMI and vaginal birth history were associated with vaginal delivery(P<0.05). Conclusion Vaginal delivery is feasible for the repregnant women with scar uterus and the multiparas usually have a better prognosis of vaginal delivery. The last cesarean section time, fetal weight, prepregnance BMI and vaginal birth history are the influencing factors of vaginal delivery of scar uterus.
Key words:  Scar uterus  Pregnancy  Vaginal delivery  Apgar score