摘要
目的:探讨剖宫产术后子宫瘢痕缺损对孕妇再次妊娠的影响。方法:2015年3月—2018年3月本院孕产的剖宫产术后子宫瘢痕缺损孕妇180例(观察组)和同期首次妊娠分娩孕妇120例(对照组),分析两组分娩结局。结果:观察组选剖宫产率(60%)较阴道试产(40%)高(P<0.05);剖宫产后阴道出血量(320.6±12.1ml)高于阴道试产者(181.1±6.6ml),新生儿Apgar评分(7.1±1.7分)低于阴道试产者(9.0±2.0分)(P<0.05),阴道试产成功率两组无差异(P>0.05);观察组产后出血量(181.1±6.6ml)、子宫切除率(8.3%)高于对照组(103.2±4.4ml、0.0%),剖宫产后出血(13.9%)、切口感染(16.7%)、盆腔粘连(14.8%)、子宫切除(6.5%)等发生率均高于对照组剖宫产者(P<0.05)。结论:剖宫产术后子宫瘢痕缺损孕妇分娩结局与无瘢痕缺损孕妇相当,如符合阴道试产条件,可鼓励孕妇选择阴道试产,对改善妊娠结局及降低剖宫产并发症发生率有一定积极作用。
Objective:To explore the influence of uterine scar defects because of history cesarean section on the pregnancy outcomes of women.Methods:180 pregnant women with uterine scar defect because of history cesarean section were selected in the observation group from March 2015 to March 2018,and other 120 first pregnancy women were enrolled into the control group during the same period.The pregnancy outcomes of women in both groups were analyzed.Results:The cesarean section rate of women in the observation group 60%,which was significant higher than that(40%)of women in the control group(P<0.05).In the observation group,the postpartum vaginal bleeding volume of women chosen cesarean section was 320.6±12.1ml,which was significant higher than that(181.1±6.6ml)of women chosen tried vaginal delivery,and neonatal Apgar score of women chosen cesarean section was 7.1±1.7 points,which was significant lower than that(9.0±2.0 points)of those women tried vaginal delivery(P<0.05).There was no significant different in success rate of vaginal delivery of women between the two groups(P>0.05).The postpartum bleeding volume(181.1±6.6ml),and hysterectomy rate(8.3%)of women in the observation group were significant higher than those[(103.2±4.4ml)and 0.0%]of women in the control group(P<0.05).After cesarean section,the incidences of postpartum hemorrhage(13.9%),incision infection(16.7%),pelvic adhesion(14.8%),and hysterectomy(6.5%)of women in the observation group were significant higher than those of women in the control group(P<0.05).Conclusion:The pregnancy outcomes of pregnant women with uterine scar defects because of history cesarean section are equivalent to those of pregnant women without scar defect.The pregnant women should be encouraged to choose vaginal delivery if they meets the conditions of vaginal delivery,which plays positive roles for improving pregnancy outcomes and reducing complications incidence of cesarean section.
作者
黄红丽
李静
黄桓
杨一
HUANG Hongli;LI Jing;HUANG Huan;YANG Yi(The Third Hospital of Wuhan City,Hubei Province,430000)
出处
《中国计划生育学杂志》
2019年第8期1061-1064,共4页
Chinese Journal of Family Planning
基金
武汉市卫生和计划生育委员会科研项目(WX18C11)
关键词
剖宫产术
子宫瘢痕缺损
再次妊娠
分娩结局
Cesarean section
Uterine scar defect
Pregnancy again
Pregnancy outcomes
