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目的探讨CS风险系数表用于剖宫产后再次妊娠产妇分娩方式的选择及其判别中的价值。方法对某院97例剖宫产史足月分娩产妇采用CS风险系数表进行阴道分娩风险值预测,观察不同预测值下阴道试产的结局。结果 (1)分娩前胎儿性别全部按照男性计算,风险值﹤20%阴道试产成功率100.00%,20%～40%阴道试产成功率86.36%,﹥40%阴道试产成功率56.25%;分娩后根据实际新生儿性别矫正CS风险值,﹤20%阴道试产成功率100.00%,20%～40%阴道试产成功率89.74%,﹥40%阴道试产成功率50.00%;(2)试产失败组与试产成功组在胎儿窘迫、新生儿窒息发生率方面差异无统计学意义(P﹥0.05),出血量、住院天数、住院费用方面差异有统计学意义(P﹤0.05);(3)阴道试产失败产妇剖宫产原因胎儿窘迫占23.08%,滞产占69.23%,先兆子宫破裂占7.69%。结论利用CS风险系数表预测有剖宫产史再次妊娠产妇阴道试产风险,风险值﹤20%阴道试产基本均可成功,﹥40%阴道分娩成功率非常小,不建议考虑阴道试产。
Objective To explore the choice of CS mode of delivery and its value in discriminating between re-pregnancy and cesarean section after CS risk coefficient table. Methods 97 cases of cesarean section history of full-term delivery of maternal CS risk factor table vaginal delivery risk prediction, vaginal trial production under different outcomes predicted outcome. Results (1) The prenatal gender of fetus was all calculated according to males, the risk value was less than 20%, the successful rate of vaginal trial was 100.00%, the success rate of vaginal trial was 20% ~ 40%, the success rate of vaginal trial was 86.36%, and the success rate of vaginal trial was> 40% 56.25%. According to the actual neonatal sex correction CS risk after delivery, <20% success rate of vaginal trial production 100.00%, 20% ~ 40% vaginal trial production success rate 89.74%,> 40% vaginal trial production success rate 50.00%; (2) There were no significant differences in the incidences of fetal distress and neonatal asphyxia between the failed trial group and the successful trial group (P> 0.05), and there was significant difference in the amount of bleeding, hospital stay and hospitalization (P <0.05). (3) vaginal pilot failed cesarean section causes fetal distress accounted for 23.08%, accounting for 69.23% of hysteresis, 7.69% of threatened uterine rupture. CONCLUSIONS: The CS risk factor table is used to predict the risk of retesting vaginal delivery in pregnant women with a history of cesarean delivery. The risk of vaginal delivery is less than 20%, and the success rate of> 40% vaginal delivery is very small. Vaginal trial production is not recommended.