摘要
目的探讨剖宫产术后再次妊娠分娩方式的选择。方法郑州大学第一附属医院2006年1月至2007年12月收治剖宫产术后再次妊娠孕妇84例,对其分娩方式、分娩结局及医疗费用进行回顾性分析。将其中剖宫产术后阴道分娩(VBAC)11例与同期非瘢痕子宫阴道分娩(VBNC)11例进行对照分析,再次剖宫产(RCS)73例与随机抽取同期首次剖宫产(PCS)73例进行对照分析。结果18例阴道试产,11例试产成功,成功率61.11%;RCS73例,手术产率86.91%。VBAC组新生儿窒息率、产时出血量、先兆子宫破裂发生率与对照组比较,差异无统计学意义(P>0.05);RCS组较VBAC组出血量大[(195.7±4.0)mL、(165.5±13.8)mL],平均住院天数多[(7.60±1.58)d、(5.20±0.22)d],医疗费用高;RCS组产后出血率(5.48%)较PCS组(0)高,差异有统计学意义(P<0.05)。结论剖宫产史并非再次剖宫产的绝对指征,无试产禁忌者可在严密监护下阴道试产。
Objectlve To study the delivery way of the re-pregnant women after caesarean section. Methods Retrospectively analyze the ways of childbirth, the results of childbirth and the cost for 84 re-pregnant women after caesarean section in the First Affiliated Hospital of Zhengzhou Univercity between Jan. 2006 and Dec. 2007. At the same time,compare the 11 cases of vaginal delivery after caesarean section with the randomly chosen 11 no-scar uterus vaginal birth of the same period, and compare the 73 cases of a second caesareatt section with the randomly chosen 73 cases of the first caesarean section（PCS） of the same period. Results Among them, 18 cases adopted trial of vaginal labor, with 11 successful ones. The success rate was 61.11%. In 73 RCS cases,the success rate of caesarean section was 86. 91%. There was no significant difference in neonatal asphyxia, postpartum hemorrhage and the incidence of uterine rupture, threatened between VBAC and VBNC. The quantity of postpartum hemorrhage of RCS was more than that of VBAC, and the average days of hospitalization were more and the cost higher. The rate of postpartum hemorrhage in RCS was higher than that of postpartum hemorrhage in PCS,with statistical significance（ P 〈 0. 05）. Conclusion Caesarean birth history is not the absolute indication of a caesarean birth. If you are fit for vaginal birth, vaginal birth is possible under intensive monitoring.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2009年第2期139-141,共3页
Chinese Journal of Practical Gynecology and Obstetrics
关键词
剖宫产
再次妊娠
分娩方式
caesarean section
re-pregnancy
delivery mode
