大理大学学报 ›› 2019, Vol. 4 ›› Issue (2): 55-.

• 临床医学 • 上一篇    下一篇

68例疤痕子宫再次妊娠经阴道分娩的可行性临床分析

杨思丽,王彬,王建萍,罗万训   

  1. (大理大学大理教学医院,云南大理671000)
  • 收稿日期:2018-08-02 修回日期:2018-12-29 出版日期:2019-02-15 发布日期:2019-02-15
  • 作者简介:杨思丽,住院医师,主要从事妇产科常见病、多发病诊治工作研究.

Clinical Analysis of the Feasibility of Vaginal Delivery for 68 Patients' Subsequent Pregnancy in#br# Scarred Uterus

Yang Sili, Wang Bin, Wang Jianping, Luo Wanxun   

  1. (Dali Teaching Hospital of Dali University,Dali, Yunnan 671000, China)
  • Received:2018-08-02 Revised:2018-12-29 Online:2019-02-15 Published:2019-02-15

摘要: [摘要]目的:对疤痕子宫再次妊娠经阴道分娩的可行性进行临床分析研究。方法:探讨2017 年1月至2017 年12 月在大理
大学大理教学医院分娩的计划性剖宫产后阴道分娩(VBAC)和非疤痕子宫阴道分娩、重复剖宫产(ERCS)与首次剖宫产的分娩
结局。结果:疤痕子宫中434例进行剖宫产后再次妊娠阴道试产(TOLAC)68例,VBAC 54例,成功率79.4%;TOLAC与非疤痕
子宫阴道分娩比较各项指标差异均无统计学意义(P>0.05);ERCS与首次剖宫产比较各项指标差异有统计学意义(P<0.05)。
结论:与ERCS相比,VBAC可减少产后出血量、缩短住院时间,有良好的母儿结局,可降低剖宫产率。对剖宫产后再次妊娠者
加强管理,积极做好应急预案,严格掌握适应症,排除禁忌证,给予适当的沟通及正确的分娩方式指导以达到有效降低剖宫产
率,减少母婴并发症的发生。

关键词: [关键词]疤痕子宫, 再次妊娠, 剖宫产, 阴道分娩

Abstract: 〔Abstract〕Objective: To study the feasibility of vaginal delivery for subsequent pregnancy in scarred uterus. Methods: We explored
the outcomes of planned VBAC and non-scar vaginal delivery, ERCS and first cesarean section delivery in Dali Teaching Hospital of
Dali University from January 2017 to December 2017. Results: Out of 434 patients with scarred uterus, 68 had TOLAC, 54 had VBAC,
and the success rate was 79.4%. No significant difference was found between TOLAC and non-scar vaginal delivery(P > 0.05). There
was a significant difference between ERCS and the first cesarean section(P < 0.05). Conclusion: Compared with ERCS, VBAC can
reduce postpartum bleeding, shorten hospitalization time, have good maternal and child outcomes, and reduce cesarean section rate. It
is necessary to strengthen the management of the subsequent pregnancy after cesarean section, make emergency plans, strictly control
the indications, eliminate contraindications, have proper communications, and offer correct childbirth guidance in order to effectively
reduce the rate of cesarean section and the incidence of maternal and infant complications.

Key words: 〔Key words〕scarred uterus, subsequent pregnancy, cesarean section, vaginal delivery