摘要
目的探讨剖宫产瘢痕子宫再次妊娠的产科处理方式及如何降低剖宫产率。方法分析总结2009年7月～2012年6月本院224例剖宫产瘢痕子宫再次妊娠分娩孕妇及同期206例初次剖宫产的临床资料。结果 224例瘢痕子宫中再次剖宫产206例,剖宫产率为91.96%;选择阴道试产24例,阴道试产率为10.70%,阴道试产成功18例,成功率为75.00%;另外6例试产失败急诊改行剖宫产;本组剖宫产、阴道分娩及初次妊娠剖宫产均未出现母婴不良情况;两组剖宫产原因相似;两组术中出血量、手术时间及腹腔粘连差异有统计学意义(P<0.05)。结论瘢痕子宫再次妊娠剖宫产率高,影响因素多,临床应加强其手术指征的掌握和产妇监控,控制初次剖宫产率,给予瘢痕子宫再次妊娠产妇试产机会,以降低剖宫产率。
Objective Discuss the clinical treatment and the way to reduce cesarean section rate for scarred uterus after a cesarean section. Methods Make an analysis of the 224 cases of repregnancy of scarred uterus after the cesarean section and 206 cases of first cesarean section from July 2009 to June 2012 in our hospital. Results Among the 224 scarred uterus cases, 206 go through another cesarean section, with the cesarean section rate standing at 91.96%.There are 24 cases of vaginal trial delivery, the rate of which being lO.70%.There are 18 successful cases of vaginal trial delivery,the success rate being 75.00%. Another 6 cases fail and resort to cesarean section.The Cesarean delivery,vaginal delivery,cesarean delivery of the first pregnancy of this time did not show any unfavorable phenomenon.Reasons of the cesarean deliveries of two times are similar. However,their blood losses,operation durations and abdominal adhesions are different from each other magnificently（P 〈 0.05）. Conclusion There are many influencing factors for the high rate of cesarean section for scarred uterus in the re-pregnancy.The clinical treatment should enhance the command of operative indications and the monitoring of the puerperas.It＇s suggested to control the first cesarean section rate and provide opportunities for trial delivery of scarred uterus in the re-pregnancy so as to reduce the cesarean section rate.
出处
《中国医药科学》
2013年第5期195-196,208,共3页
China Medicine And Pharmacy
关键词
剖宫产
再次妊娠
子宫破裂
再次剖宫产
阴道试产
Cesarean section
Re-pregnancy
Hysterorrhexis
Another cesarean section
Vaginal trial delivery
