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目的探讨剖宫产术后再次妊娠的合理分娩方式,以降低再次剖宫产率。方法选取2011年1月至2015年1月收治的180例剖宫产术后再次妊娠孕妇,根据妊娠是否合并胎盘附着位置异常、子宫切口愈合不良、重度子痫前期等各种高危因素,分为高危组和低危组,高危组孕妇均行再次剖宫产术,低危组孕妇分为再次剖宫产组和经阴道分娩组,对低危组孕妇再次分娩方式、妊娠结局、住院费用及新生儿窒息率进行综合比较。结果 180例孕妇中高危组42例,低危组138例,低危组中再次剖宫产105例(76.1%),经阴道分娩33例(23.9%);经阴道分娩组产妇产时出血量、住院时间、住院费用优于再次剖宫产组(P<0.05);经阴道分娩组产褥病率为3.0%,低于剖宫产组(P<0.05);两组先兆子宫破裂发生率与新生儿窒息率比较差异未见统计学意义(P>0.05)。结论对剖宫产术后再次妊娠孕妇应行仔细检查,低危孕妇可合理选择阴道试产,降低再次剖宫产率。
Objective To investigate the reasonable mode of delivery of cesarean section after pregnancy again to reduce the rate of cesarean section. Methods From January 2011 to January 2015, 180 pregnant women undergoing cesarean section after pregnancy were enrolled, and were divided into three groups according to the pregnancy risk factors such as abnormal placenta accreta, poor healing of uterine incision and severe preeclampsia The high-risk group and low-risk group, high-risk group of pregnant women underwent cesarean section again, low-risk group pregnant women were divided into cesarean section group and vaginal delivery group, low-risk group pregnant women again mode of delivery, pregnancy outcome, hospitalization costs and Neonatal asphyxia rate for a comprehensive comparison. Results Among the 180 pregnant women, 42 were middle-high-risk group and 138 were low-risk group. In the low-risk group, 105 (76.1%) had another cesarean section and 33 (23.9%) had vaginal delivery. (P <0.05). The rate of puerperal was 3.0% in vaginal delivery group, which was lower than that in cesarean section group (P <0.05). The incidence of threatened uterine rupture Rate and neonatal asphyxia rate difference was not statistically significant (P> 0.05). Conclusion Reproductive pregnant women after cesarean section should be carefully examined, low-risk pregnant women can choose a reasonable vaginal trial production, reduce the rate of cesarean section again.