瘢痕子宫再次妊娠阴道分娩的可行性分析

聂引凡

（陕西省咸阳市乾县人民医院，陕西 咸阳，713300）

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摘要：

目的 探讨对瘢痕子宫产妇实施再次妊娠阴道分娩的可行性。方法 选择我院2013年8月至2016年8月收治的瘢痕子 宫再次妊娠临床实施阴道分娩产妇作为本次试验的观察组（40例），并同期选择第一胎临床实施阴道分娩产妇作为本次试验的对照组（40例），对两组产妇阴道分娩成功率、产时出血量及产后出血量等指标进行对比。结果 在阴道分娩成功率上，两组产妇未表现出显著差异（P>0.05）；在出现先兆子宫破裂症状、产后感染症状及产后出血等系列症状概率上，两组产妇未表现 出显著差异（P>0.05）；在新生儿Apgar评分、产时出血量及住院时间等方面，两组产妇未表现出显著差异（P>0.05）。结论 对于瘢痕子宫再次妊娠产妇，应对其基本情况进行认真评估，且有效掌握其临床指征，可实施阴道分娩，可行性较高；在产程阶段，需要做好监测工作，当产妇表现出不良情况时，临床应及时选择实施剖宫产。

关键词：瘢痕子宫；再次妊娠；阴道分娩

中图分类号：R719.8文献标志码：A文章编号：2096-1413(2017)16-0132-02

Feasibility analysis of vaginal delivery of scarred uterus in second pregnancy
NIE Yin-fan
（Qian County People`s Hospital of Xianyang, Xianyang 713300, China）

ABSTRACT: Objective To explore the feasibility of vaginal delivery for pregnant women with scarred uterus in second pregnancy. Methods A total of 40 cases of pregnant women performing pregnancy vaginal delivery again from August 2013 to August 2016 were selected as the observation group, while 40 cases of pregnant women performing pregnancy vaginal delivery for the first time were selected as the control group. The success rate of vaginal delivery, amount of bleeding in the course of labor and the amount of bleeding after childbirth were compared between the two groups. Results The success rate of vaginal delivery showed no significant difference between the two groups (P >0.05). There was no significant
difference in the presence of signs of rupture of the uterus, symptoms of postpartum infection and postpartum hemorrhage between the two groups (P>0.05). There was no significant difference in the neonatal Apgar score, intrapartum bleeding volume and length of stay between the two groups (P>0.05). Conclusion For the pregnant women performing pregnancy vaginal delivery again, evaluating the condition, grasping the clinical indicators and performing the vaginal delivery are very important, with higher feasibility. The clinical monitoring should be done during the delivery, cesarean delivery, which should be considered at the first time if there is any adverse situation.
KEYWORDS: scarred uterus; pregnancy again; vaginal delivery

参考文献：
[1] 陆莹,郑疆.剖宫产瘢痕子宫妇女再次妊娠阴道分娩的临床观察 [J].中国计划生育学杂志,2015,23(4):254-256.
[2] 张楠莹.瘢痕子宫再次妊娠阴道分娩的可行性分析及注意事项[J]. 中国实用护理杂志,2012,28(2):68-69.
[3] 何涓.瘢痕子宫再次妊娠阴道分娩的可行性及安全性分析[J].现代中西医结合杂志,2015,24(23):2568-2570.
[4] 张园园,余后火.瘢痕子宫初次子宫不同缝合方式对再次妊娠阴道分娩的影响[J].中国妇幼健康研究,2015,26(6):1259-1261.
[5] 董明珍.瘢痕子宫再次妊娠阴道分娩临床效果及安全性分析[J].临床和实验医学杂志,2012,11(9):711,713.
[6] 倪小红.一对一强化监测在瘢痕子宫再次妊娠阴道分娩中的应用研究[J].国际护理学杂志,2013,32(4):789-791.
[7] 周鑫广,张俊清,李莉,等.剖宫产术后瘢痕子宫再次妊娠阴道分娩的临床分析[J].中国卫生标准管理,2015,6(17):55-58.
[8] 臧灵琳,李红梅,刘秋香,等.瘢痕子宫再次妊娠阴道分娩临床效果及安全性分析[J].世界临床医学,2015,9(6):52.
[9] 王兰.瘢痕子宫再次妊娠阴道分娩66 例产程护理分析[J].中外医学研究,2014,12(6):117-118.
[10] 翁晓贤.瘢痕子宫再次妊娠阴道分娩临床效果与安全性[J].现代诊断与治疗,2014,25(14):3304-3305.