疤痕子宫经阴道分娩适应症探讨.pdf

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1、2015年第36卷第18期JournalofQiqiharUniversityofMedicine．2015．Vo1．36．No．18·2681·．经验交流．疤痕子宫经阴道分娩适应症探讨邓霞梅【摘要】目的总结探讨疤痕子宫足月妊娠经阴道分娩适应症，以期降低临床剖宫产率。方法回顾分析我院收治的160例疤痕子宫再次妊娠阴道分娩成功者及160例疤痕子宫剖宫产者的临床资料，总结分析其疤痕厚度、产程时间胎儿体重、距离上次剖宫产时间等。另外选择同期妇产科收治的160例非疤痕子宫经阴道分娩成功者为对照组研究对象，对比分析疤痕子宫与非疤痕子宫产妇的产程、出血量、新生儿Apgar评分等差

2、异。结果疤痕子宫孕妇阴道分娩成功孕妇的年龄(25．5±2．5)岁、胎儿体重(3．2±0．8)kg明显低于疤痕子宫剖宫产组，而疤痕厚度(3．5±1．1)mm及距离上次剖宫产时间(2．1±0．5)年明显高于剖宫产组，差异具有统计学意义(P<0．05)；疤痕子宫阴道分娩组孕妇与非疤痕子宫阴道分娩组孕妇在产程、出血量、新生儿Apgar评分等方面均不具有统计学差异(P>0．05)。结论产妇年龄在40岁以下、剖宫产次数1次、距上次剖宫产2年以上、胎儿体重4kg以内者可选择阴道试产，且成功率较高。【关键词】疤痕子宫；阴道分娩；适应症Clinicalstudyofvaginaldel

3、iveryindicationsforscaruterusDENGX／a—mei．DepartmentofGynecology．YuebeiPeople'sHospital，Shaoguan，Guangdong512026，China．【Abstract】0bjecfiveToinvestigatevaginaldeliveryindicationsscaruterusattermpregnancyinordertoreducetherateofcesareansection．MethodsClinicaldataof160casesofuterinescarpreg

4、nancyagainSuccessfulvaginaldeliveryand160casesofscaruteruswithcesareansectioninourhospitalwerereviewed．Scarthickness．1abortimefetalweightfromthelasttimecesareansectionweresummarized．AlsochoosethesameperiodofObstetricsandGynecologytreated160casesofnon．uterinescarsuccessfulvaginaldelivery

5、asthecontrolgroup，thematernallabor，hemorrhageandneonatalApgarscoreofuterinescarandnon—uterinescarwereanalyzed．ResultsTheuterinescarSuccessfulvaginaldeliverymaternalage(25．5±2．5)yearsofage，fetalweight(3．2±0．8)kggroupwassignificantlylowerthancesareanuterinescar，andscarthickness(3．5±1．1)mm

6、anddistancelasttimecesareansection(2．1±0．5)wassignificantlyhigherthaninthecesareansectiongroup(P<0．05)．Thematernallabor，hemorrhageandneonatalApgarscoreofuterinescarandnon—uterinesearwerenotsignificantdifference(P>0．05)．ConclusionsMaternalageunder40years，onetimeofcesareansection，cesarean

7、sectionfromthelastmorethantwoyears，fetalweighttessthan4kgmaychoosevaginaltrialproduction．【Keywords】Scaruterus；Vaginaldelivery；Indications瘢痕子宫是指剖宫产手术或肌壁间肌瘤剥除术后的子例、原因不明者20例。②疤痕子宫再次选择剖宫产者：年龄宫。瘢痕子宫再次妊娠可能发生子宫破裂、产后出血、前置胎19—40岁，平均(32．5±2．5)岁；孕周37～4O周；距离上次剖盘等，瘢痕子宫孕行剖宫产分娩时，损伤、感染、粘连加重、宫产