瘢痕子宮再妊娠分娩方式選擇的臨床探析

[摘要] 目的 對(duì)瘢痕子宮再妊娠產(chǎn)婦的臨床分娩方式選擇進(jìn)行探析。方法 方便選取該院自2012年5月—2016年5月期間所收治的76例瘢痕子宮再妊娠產(chǎn)婦，回顧性分析產(chǎn)婦再妊娠分娩方式的選擇以及對(duì)新生兒的影響。結(jié)果 76例產(chǎn)婦中，選擇陰道試產(chǎn)的產(chǎn)婦例數(shù)為50例，陰道試產(chǎn)率為65.7%，陰道試產(chǎn)成功例數(shù)為40例，成功率為80%；產(chǎn)前選擇剖宮產(chǎn)的產(chǎn)婦例數(shù)為26例，實(shí)際采用剖宮產(chǎn)的產(chǎn)婦例數(shù)為36例。陰道試產(chǎn)組的產(chǎn)時(shí)出血量、產(chǎn)程時(shí)間、感染情況上均顯著性低于剖宮產(chǎn)組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；將陰道試產(chǎn)組的新生兒Apgar評(píng)分與剖宮產(chǎn)組對(duì)比，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論 瘢痕子宮再妊娠產(chǎn)婦在進(jìn)行臨床分娩方式選擇需要進(jìn)行綜合考慮，需要根據(jù)產(chǎn)婦的實(shí)際臨床情況，制定出科學(xué)合理的分娩方案，確保產(chǎn)婦使用最佳方案進(jìn)行分娩。

[關(guān)鍵詞] 瘢痕子宮；再妊娠；分娩方式

[中圖分類號(hào)] R5 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-0742（2016）11（a）-0046-03

[Abstract] Objective To discuss the choice of clinical delivery mode for the pregnant women with scar uterus. Methods Convenient selection 76 cases of uterine scar pregnancy in our hospital from May 2012 to May 2016 were selected and analyzed retrospectively. Results 76 cases of pregnant women， the choice of the number of cases of maternal vaginal delivery of 50 cases， vaginal delivery rate was 65.7%， the number of vaginal delivery was successful cases for 40 cases， the success rate was 80%； prenatal choose cesarean section maternal cases number for the 26 cases， the actual use of the 36 cases of cesarean section maternal cases. Vaginal trial production group of intrapartum hemorrhage volume， labor time， infection were significantly lower than Caesarean birth group， the difference is statistically significant （P < 0.05）； the vaginal delivery group neonatal Apgar score and cesarean section to produce the contrast group， the difference was not significant， there is no statistical significance（P > 0.05）. Conclusion Uterine scar to pregnant women were clinical delivery mode selection requires a comprehensive consideration， need according to the actual clinical situation of maternal， formulate scientific and reasonable delivery plan， ensure maternal use of optimal scheme for labor.

[Key words] Scar uterus； Re-pregnancy； Delivery mode

瘢痕子宮是指經(jīng)過剖宮產(chǎn)手術(shù)或者經(jīng)過肌壁間肌瘤剝除術(shù)后的子宮，其發(fā)病率隨著剖宮產(chǎn)率的逐年上升而逐年增加，對(duì)產(chǎn)婦的再妊娠造成了極大的影響，成為了產(chǎn)科分娩過程中需要解決的重大醫(yī)療課題之一。瘢痕子宮產(chǎn)婦在再妊娠過程中易發(fā)生子宮破裂，嚴(yán)重時(shí)甚至?xí)＜靶律鷥阂约爱a(chǎn)婦的生命安全[1]，因此，臨床上在對(duì)瘢痕子宮再妊娠產(chǎn)婦的臨床分娩方式進(jìn)行選擇時(shí)十分慎重，需要全面考慮產(chǎn)婦的身體情況[2]，為產(chǎn)婦選擇科學(xué)合理的分娩方式，有效控制產(chǎn)婦分娩過程中的出血量、產(chǎn)程用時(shí)以及感染情況，保證產(chǎn)婦在分娩過程中的安全性。……