目的探讨瘢痕子宫孕妇再次分娩方式的选择和相关危险因素。方法回顾性分析2016年2月-2017年2月在该院住院分娩、有剖宫产史的156例瘢痕子宫孕妇的临床资料,根据最终分娩方式分为自然分娩组(125例)和剖宫产组(31例),比较两种分娩方式预后,分析相关危险因素。结果 156例瘢痕子宫孕妇,阴道试产成功125例,中途转剖宫产术31例;两组孕妇新生儿出生后5min Apgar评分比较差异无统计学意义(P>0.05);自然分娩组孕妇产时出血量明显少于剖宫产组,住院时间明显短于剖宫产组,产后感染及产后出血等并发症发生率明显低于剖宫产组(均P<0.05);多元Logistic回归分析,孕妇产前BMI>30 kg/m~2、宫颈长度>28 mm、距离前次剖宫产时间≤2年是影响阴道试产顺利进行的独立危险因素(P<0.05)。结论瘢痕子宫孕妇经阴道分娩安全可行,对孕妇和新生儿影响小,临床应结合相关危险因素指导孕妇选择最佳分娩方式。 Objective To investigate the choice of the mode of delivery for pregnant women with scar uterus and related risk factors. Methods The clinical data of 156 cases of uterine scar from January 2016 to February 2017 with hospital delivery and cesarean section were retrospectively analyzed. According to the final mode of delivery, they were divided into two groups: natural delivery group (125 cases) and cesarean section Production group (31 cases), compared the prognosis of two modes of delivery, analysis of risk factors. Results 156 cases of uterus scar pregnancy, vaginal trial success 125 cases, midway cesarean section in 31 cases; two groups of newborns 5min after birth Apgar score was no significant difference (P> 0.05); natural delivery group pregnant women (P0.05) .Multivariate logistic regression analysis showed that the incidence of postpartum infection and postpartum hemorrhage was significantly lower than that of cesarean section (P0.05) Prenatal BMI> 30 kg / m ~ 2 and cervical length> 28 mm were independent risk factors (P <0.05) of the vagina trial from ≤2 years before the cesarean section. Conclusions Transvaginal delivery of pregnant women with scarring uterus is safe and feasible, and has little effect on pregnant women and newborns. The pregnant women should be guided to choose the best mode of delivery in combination with relevant risk factors.