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目的探讨剖宫产瘢痕子宫再次妊娠的分娩方式。方法对2009年1月至2010年12月208例瘢痕子宫再次妊娠病例分娩方式作回顾性分析。结果阴道试产30例,成功率90.0%(27/30),没有发生子宫破裂,出血量约200～300 ml。再次剖宫产181例,拒绝试产178例,其中34例有剖宫产指征,出血量200～500 ml。结论对于剖宫产瘢痕子宫再次妊娠的产妇,在妊娠晚期行B超检查子宫下段瘢痕厚度,再次分娩方式的选择应多方面考虑,并严格掌握适应证和禁忌证,阴道试产是可选择的一种措施,可提高产科质量,降低剖宫产率。
Objective To investigate the delivery mode of cesarean scar pregnancy again. Methods A retrospective analysis was performed on 208 cases of uterine scar pregnancy between January 2009 and December 2010. Results 30 cases of vaginal trial, the success rate of 90.0% (27/30), uterine rupture did not occur, the amount of bleeding about 200 ~ 300 ml. Again cesarean section in 181 cases, refused to trial 178 cases, of which 34 cases of cesarean indications, bleeding 200 ~ 500 ml. Conclusion For cesarean scar pregnancy uterus again pregnant women, in the third trimester of pregnancy underwent uterine fibroids scar thickness, re-delivery mode should be considered in many ways, and strict indications and contraindications, vaginal trial is optional A measure to improve obstetric quality, reduce cesarean section rate.