剖宫产后阴道分娩与非瘢痕子宫阴道分娩的临床分析

易淑文

（扶风县妇幼保健院，陕西 宝鸡，722200）

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摘要：

目的 分析剖宫产后阴道分娩与非瘢痕子宫阴道分娩的分娩结局。方法 将我院2014年6月至2015年12月收治的60例剖宫产后再次妊娠阴道分娩产妇设为观察组，并选取同期非瘢痕子宫阴道分娩产妇60例为对照组，比较两组产妇的产程、产后出血量、住院时间、输血率、会阴切开率等妊娠结局及新生儿Apgar评分、新生儿体重、新生儿窒息发生率等。结果  两组产妇的产程、产后出血量、住院时间、输血率、会阴切开率比较，差异无统计学意义（P>0.05）。两组新生儿Apgar评分、体重、窒息发生率比较，差异无统计学意义（P>0.05）。结论 剖宫产后阴道分娩是安全可行的，这为剖宫产术后分娩方式的选择提供一定依据，但需严格掌握引产的适应证及禁忌证，最大程度地避免不良事件的发生。

关键词：剖宫产；阴道分娩；非瘢痕子宫；妊娠结局；新生儿结局

中图分类号：R714文献标志码：A文章编号：2096-1413(2017)27-0136-02

Clinical analysis of vaginal delivery after cesarean section and non scar uterus vaginal delivery
YI Shu-wen
(Maternal and Child Health Care of Fufeng County, Baoji 722200, China)

ABSTRACT: Objective To analyze the outcome of vaginal delivery after cesarean section and non scar uterus vaginal delivery. Methods Sixty cases of vaginal delivery after cesarean section in our hospital from June 2014 to December 2015 were selected as the observation group. Another 60 cases of non scar vaginal delivery were selected as the control group. The pregnancy outcome such as the birth process, amount of postpartum hemorrhage, length of hospital stay, rate of blood transfusion and rate of episiotomy, Apgar score, neonatal weight, incidence of neonatal asphyxia were compared between the two groups. Results There were no significant differences between the two groups in the birth process, amount of postpartum hemorrhage, length of hospital stays, rate of blood transfusion and rate of episiotomy (P>0.05). There were no significant differences between the two groups in Apgar score, neonatal weight and incidence of neonatal asphyxia (P>0.05). Conclusion Vaginal delivery after cesarean section is safe and feasible, which can provide some basis for the choice of delivery mode after cesarean section. However, it is necessary to strictly grasp the indications, contraindications of induction of labor and to avoid the occurrence of adverse events to the greatest exten.
KEYWORDS：cesarean section; vaginal delivery; non scar uterus; pregnancy outcome; neonatal outcome

参考文献：
[1] 张静涛,张蕊,贾蕊莉,等.剖宫产术后瘢痕子宫再次足月妊娠阴道分娩240例临床分析[J].陕西医学杂志,2016,45(5):583-584.
[2] 贾书方,李静,杨春华.瘢痕子宫产妇二次剖宫产并发症发生情况及与非瘢痕子宫剖宫产的对照研究[J].中国妇幼保健,2016,31(1):65-66.
[3] 刘丽恒,姜海利,王欣.剖宫产后再次妊娠阴道分娩的临床分析[J]. 中国临床医生杂志,2016,44(6):80-82.
[4] 欧玉华,张建平.如何看待孕妇要求的剖宫产[J].实用妇产科杂志,2015,31(4):247-249.
[5] 周圣涛,张力.瘢痕子宫妊娠阴道试产的研究进展[J].中华妇产科杂志,2015,50(4):305-308.
[6] 张茗,王孝贤,尚丽莉,等.瘢痕子宫与非瘢痕子宫阴道试产的临床结局比较[J].大连医科大学学报,2015,37(6):589-591.
[7] 顾春怡,丁焱,朱新丽.剖宫产术后阴道试产妇女的围产期评估与管理现状[J].中华护理杂志,2015,50(4):463-467.
[8] 何镭,陈锰,何国琳,等.剖宫产术后再次妊娠阴道分娩孕妇的妊娠结局分析[J].中华妇产科杂志,2016,51(8):586-591.
[9] GIBBINS KJ,WEBER T,HOLMGREN CM,et al.Maternal and fetal morbidity associated with uterine rupture of the unscarred uterus[J].Am J Obstet Gynecol,2015,213(3):1-6.
[10] 余琳,苏春宏,王晓怡,等.剖宫产术后再次妊娠阴道试产的多中心临床研究[J].中华妇产科杂志,2016,51(8):581-585.
[11] BUJOLD E,GAUTHIER RJ.Risk of uterine rupture associated with an interdelivery interval between 18 and 24 months[J].Obstet Gynecol, 2010,115(5):1003-1006.