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目的分析瘢痕子宫产妇再次分娩的指证以及选择不同分娩方式的优势。方法选取2013年1月至2016年6月于安徽省六安市人民医院分娩的瘢痕子宫产妇共计166例,详细记录其分娩方式以及产后24 h的出血情况、发热情况、是否存在产褥病例。记录新生儿出生健康情况指标、是否有新生儿窒息,统计不同分娩方式产妇住院总需时间以及医疗相关费用。回顾性分析并比较不同分娩方式上述结果差异,总结不同分娩方式的选择优势。结果阴道试分娩产妇共计90例,阴道试产成功率75.56%;剖宫产孕妇共计76(45.78%)例。瘢痕子宫产妇行剖宫产与阴道分娩相比,其24 h出血量以及产后发热情况明显增多(P﹤0.05),新生儿窒息比例明显增多(P﹤0.05)。行剖宫产孕妇其住院总需时间以及花费均明显高于阴道分娩产妇(P﹤0.05)。其余指标均未见明显差异(P﹥0.05)。结论相对剖宫产的分娩方式,阴道分娩对于再次分娩瘢痕子宫产妇及新生儿的不良影响较小,具有明显选择优势,临床应首先选择阴道分娩。
Objective To analyze the indications of the second delivery of scar maternal uterus and the advantages of choosing different modes of delivery. Methods A total of 166 cases of scarring uterus delivered from Jan. 2013 to Jun. 2016 in Lu’an People’s Hospital of Anhui Province were selected. The modes of delivery and the bleeding at 24 hours postpartum were recorded in detail. The fever and whether there were puerperal cases were recorded. Record newborn birth health indicators, whether there is neonatal asphyxia, statistics of different modes of delivery maternal hospital total time and medical costs. Retrospective analysis and comparison of different modes of delivery differences in the above results, summarizes the advantages of different modes of delivery. Results A total of 90 vaginal delivery mothers, vaginal trial 75.56% success rate; a total of 76 (45.78%) cesarean section pregnant women. Compared with vaginal delivery, the cesarean section of scar-shaped uterus was significantly increased (P <0.05) and the proportion of neonatal asphyxia was significantly increased (P <0.05). Cesarean section cesarean section of their total length of hospital stay and costs were significantly higher than vaginal delivery of mothers (P <0.05). The remaining indicators were not significantly different (P> 0.05). Conclusion Compared with cesarean delivery, vaginal delivery has little adverse effect on the delivery of scarring uterus and newborn, which has the obvious advantage of choice. Vaginal delivery should be the first choice in clinical practice.