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目的探讨瘢痕子宫足月妊娠不同分娩方式结局并分析相关因素。方法对2009年6月—2011年6月怀化市第二人民医院180例瘢痕子宫足月妊娠孕产妇临床资料进行回顾性分析。结果 180例孕产妇中阴道试产55例,成功49例(89.1%);行剖宫产131例(72.8%),其中社会因素剖宫产40例(30.5%);阴道分娩组与再次剖宫产组患者产后出血量分别为(119.80±17.62)mL和(468.90±56.94)mL,差别具有统计学意义(P<0.05);阴道分娩组住院天数显著少于再次剖宫产组(3.75±0.42 vs 7.59±0.69 d,P<0.05);两组新生儿Apger评分差别无统计学意义(P>0.05)。结论社会因素在瘢痕子宫再次剖宫产中占有较大比重,瘢痕子宫并非剖宫产绝对指征,对于具备试产条件者应在密切监护进行阴道分娩。加强对产妇的健康教育及产科医师的业务培训,有助于降低剖宫产率。
Objective To investigate the outcome of different modes of delivery in full-term pregnancy of scar and analyze the related factors. Methods The clinical data of 180 pregnant women with full-term scar pregnancy from June 2009 to June 2011 in People’s Hospital of Huaihua City were analyzed retrospectively. Results Among the 180 pregnant women, 55 were vaginal trial, 49 cases were successful (89.1%), 131 cases (72.8%) were cesarean section, 40 were cesarean section (30.5%), The postpartum hemorrhage volume in the uterine group was (119.80 ± 17.62) mL and (468.90 ± 56.94) mL, respectively, with statistical significance (P <0.05). The number of days of hospitalization in the vaginal delivery group was significantly less than that in the cesarean section group (3.75 ± 0.42 vs 7.59 ± 0.69 d, P <0.05). There was no significant difference in Apger score between the two groups (P> 0.05). Conclusion Social factors occupy a larger proportion of cesarean section in scarring uterus. Scarring uterus is not an absolute indication of cesarean section. Vaginal delivery should be performed in close monitoring for those with trial production. Strengthening maternal health education and professional training of obstetricians will help reduce cesarean section rates.