瘢痕子宫与非瘢痕子宫阴道试产的临床结局比较

Clinical outcome of vaginal delivery in scarred and non-scarred uterus

关键词:  瘢痕子宫  妊娠  阴道分娩

Key words:  scar uterus  pregnancy  vaginal delivery

摘要:

目的　通过比较瘢痕子宫与非瘢痕子宫阴道试产的临床结局，探讨瘢痕子宫再次足月妊娠阴道试产的可行性和安全性。　方法　收集2012年1月至2015年1月瘢痕子宫阴道试产159例患者（瘢痕子宫组）的临床资料，并选取同期非瘢痕子宫阴道分娩的患者162例作为对照组。对两组中转剖宫产率、助产率、产程、胎儿窘迫率、产后出血率、产后尿潴留发生几率进行比较。　结果　　瘢痕子宫组的中转剖宫产率、助产率、产后出血率高于对照组，差异均具有显著性意义（P<0.05）；而在产程、胎儿窘迫率、产后尿潴留发生几率方面两组无明显差异（P>0.05）。　结论　　在掌握好瘢痕子宫阴道试产的适应证情况下，瘢痕子宫进行阴道试产是完全可行的。

Abstract:

Objective By comparing the clinical outcomes between the scarred uterus and non-scarred uterus during vaginal trial of labor, to study the feasibility and safety of vaginal birth after cesarean delivery in full-term pregnancy. Methods Cases between 01/2012 and 01/2015 were retrospectively reviewed. Totally, 159 pregnant women, who had scarred uterus and vaginal trial of labor, were presented as experimental group and 162 cases of vaginal delivery with non-scarred uterus as control group. The rates of cesarean delivery, assisted delivery, intrauterine asphyxia, postpartum bleeding, urinary retention and fetal distress were analyzed. Results There were significantly higher rates of cesarean delivery, assisted delivery and postpartum bleeding（P<0.05）in the experimental group compared to the control group. No significant differences were observed in the rate of intrauterine asphyxia, postpartum urinary retention and fetal distress（P>0.05）between the two groups. Conclusion Vaginal delivery in scarred uterus is feasible if indications for trial of labor are strictly followed.