摘要
目的 探讨前次剖宫产手术时机对再孕阴道分娩母婴并发症的影响.方法 回顾性分析本院收治的 1 034 例足月剖宫产术后阴道分娩(VBAC)孕产妇资料.按前次剖宫产手术时机分为择期组(择期行剖宫产术)426 例、第一产程组(第一产程行剖宫产术)278 例、第二产程组(第二产程行剖宫产术)330 例.分析前次剖宫产手术时机对VBAC孕产妇的产程、产后并发症及新生儿出生情况的影响.结果 第二产程组子宫收缩乏力比例、产后24h出血量、产后出血发生率及产后住院天数均大于择期组和第一产程组(P<0.05),而择期组与第一产程组比较,以上指标差异无统计学意义(P>0.05).3 组间第二、第三产程时限、助产率、会阴裂伤率、产后尿潴留率、发热比例及新生儿 1 min Apgar评分、新生儿窒息发生率及转入新生儿科比例比较,差异无统计学意义(P>0.05).结论 前次第二产程剖宫产手术孕产妇再孕阴道分娩时发生子宫收缩乏力及产后出血风险增加.
Abstract
Aim To explore impact of maternal and infant complications during vaginal delivery by timing of previous cesare-an section surgery.Methods Retrospective analysis of 1 034 cases of vaginal delivery(VBAC)after full term cesarean section admitted to our hospital.According to the timing of previous cesarean section,426 cases were divided into elective group(elective cesarean section),278 cases were divided into first stage of labor group(cesarean section in the first stage of labor)and 330 cases were divided into second stage of labor group(cesarean section in the second stage of labor).The effect of previous cesarean section timing on labor process,postpartum complications and neonatal birth condition of VBAC was analyzed.Results The rate of uter-ine inertia,24 hours postpartum hemorrhage,incidence of postpartum hemorrhage and postpartum hospitalization days of second stage of labor group were higher than those in elective group and first stage of labor group(P<0.05),and those items had no statistical difference between elective group and first stage of labor group(P>0.05).There was no significant difference in the time limit of the second and third stages of labor,midwifery rate,perineal laceration rate,postpartum urinary retention rate,fever rate,Apgar score at 1 min of the newborn,incidence of neonatal asphyxia and the proportion of transferred to neonatal department among the three groups(P>0.05).Conclusion Pregnant women who underwent the previous second stage cesarean section surgery have an increased risk of uterine atony and postpartum hemorrhage during vaginal delivery.
维普
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