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    高宇洁, 施晓梅. 瘢痕子宫再次分娩时不同分娩方式间各影响差异及其相关性研究[J]. 蚌埠医科大学学报, 2019, 44(8): 1051-1055. DOI: 10.13898/j.cnki.issn.1000-2200.2019.08.020
    引用本文: 高宇洁, 施晓梅. 瘢痕子宫再次分娩时不同分娩方式间各影响差异及其相关性研究[J]. 蚌埠医科大学学报, 2019, 44(8): 1051-1055. DOI: 10.13898/j.cnki.issn.1000-2200.2019.08.020
    shu
    GAO Yu-jie, SHI Xiao-mei. Study on the influencing factors of different delivery modes on scar uterus redelivery and its correlation analysis[J]. Journal of Bengbu Medical University, 2019, 44(8): 1051-1055. DOI: 10.13898/j.cnki.issn.1000-2200.2019.08.020
    Citation: GAO Yu-jie, SHI Xiao-mei. Study on the influencing factors of different delivery modes on scar uterus redelivery and its correlation analysis[J]. Journal of Bengbu Medical University, 2019, 44(8): 1051-1055. DOI: 10.13898/j.cnki.issn.1000-2200.2019.08.020
    shu

    瘢痕子宫再次分娩时不同分娩方式间各影响差异及其相关性研究

    Study on the influencing factors of different delivery modes on scar uterus redelivery and its correlation analysis

      摘要
    • 摘要:
      目的瘢痕子宫再次分娩时分娩方式选择影响因素及其相关性研究。
      方法选取2017年1月至2019年5月接收的瘢痕子宫待产孕妇207例，所有孕妇均选择阴道试产分娩，根据试产结局将其分为试产成功组和试产失败组，即阴道分娩组和再次剖宫产组，分别131例和76例。比较2组孕妇的产时出血量、产程时间、产褥病率、新生儿Apgar评分以及各临床资料差异，同时采用多因素logistic回归分析各临床资料对孕妇分娩方式选择影响。
      结果再次剖宫产组的产时出血量、产程时间、产褥病率均明显高于阴道分娩组（P＜0.01），再次剖宫产组与阴道分娩组的年龄、孕周、产前体质量指数（BMI）、距前次剖宫产间隔时间、子宫下段厚度、阴道分娩情况、胎儿估重、分娩前宫颈评分等产前因素和潜伏期时间、尿潴留、临产后胎方位、宫缩程度、潜伏期宫颈评分等产时因素比较具有差异均有统计学意义（P＜0.01），多因素logistic回归分析显示，年龄、孕周、距前次剖宫产间隔时间、子宫下段厚度、胎儿估重、分娩前宫颈评分、产前BMI、阴道分娩情况、潜伏期时间、尿潴留、临产后胎方位、宫缩程度、潜伏期宫颈评分等产前和产时因素均是影响剖宫产后阴道分娩成功率的独立危险因素（P＜0.05~P＜0.01）。
      结论在严格筛选年龄、产前BMI、上次剖宫产间隔时间、阴道分娩史、定期产前检查、瘢痕厚度等适应指征情况下，瘢痕子宫再次妊娠孕妇选择阴道分娩，有助于改善孕妇分娩结局，提高分娩安全性。

       

      Abstract:
      ObjectiveTo study the influencing factors of the choice of delivery mode in scar uterus redelivery and its correlation analysis.
      MethodsThe vaginal trial delivery in 207 pregnant women with scar uterus were chose.According to the outcome of trial delivery, the pregnant women were divided into the successful trial delivery group and failed trial delivery group, namely vaginal delivery group(131 cases) and repeat cesarean section group(76 cases).The blood loss, duration of labor, rate of puerperal disease, Apgar score and clinical data of neonates were compared between two groups, and the influence of various clinical data on the choice of delivery mode of pregnant women were analyzed using multifactor logistic regression.
      ResultsThe blood loss during delivery, duration of labor and rate of puerperal disease in repeat cesarean section group were significantly lower than those in vaginal delivery group(P < 0.01).The differences of the age, gestational week, prenatal body mass index(BMI), interval from previous cesarean section, thickness of the lower uterine segment, vaginal delivery, estimating fetal weight, cervical score, incubation period, urinary retention, fetal position after birth, degree of contraction and incubation cervical score were statistically significant between two groups(P < 0.01).The results of logistic regression analysis showed that the age, gestational week, prenatal BMI, interval from previous cesarean section, lower uterine thickness, fetal weight estimation, cervix score before delivery, vaginal delivery, incubation period, urinary retention, postnatal fetal position, degree of uterine contraction and incubation cervical score were the independent risk factors of the success rate of VBAC(P < 0.05 to P < 0.01).
      ConclusionsAfter the age, prenatal BMI, interval from last cesarean section, history of vaginal delivery, regular prenatal examination and scar thickness are strictly screened, the choice of vaginal delivery for pregnant women with scar uterus in the second pregnancy is helpful to improve the outcome of pregnant women's delivery and safety of delivery.

       

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