超声下瘢痕子宫再次妊娠产妇的分娩方式分析及对产妇、新生儿的影响
Analysis of the mode of delivery of pregnant women with scarred uterus by ultrasound and its impact on mothers and neonates
李娇 1李振洲2
作者信息
- 1. 深圳市大鹏新区妇幼保健院超声科 广东 深圳 518120;汕头大学医学院 广东 汕头 515041
- 2. 深圳市第二人民医院超声科 广东 深圳 518035
- 折叠
摘要
目的:探究瘢痕子宫再次妊娠产妇的分娩方式及对产妇、新生儿的影响.方法:选择 2021 年 1 月—2023 年 6 月深圳市大鹏新区妇幼保健院收治的瘢痕子宫再次妊娠孕妇86例作为研究对象,根据分娩方式的不同进行分组,对照组(n=43)行再次剖宫产,观察组(n=43)行阴道分娩,比较两组分娩情况(产程时间、产中出血量、住院时间、新生儿Apgar评分、分娩成功率)、(妊娠期、分娩期及产褥期)并发症发生率、新生儿并发症发生率、发育情况,以及观察子宫瘢痕在超声分级下对其妊娠分娩结局的影响.结果:观察组产程时间、新生儿Apgar评分均高于对照组,产中出血量及住院时间均少于对照组,差异有统计学意义(P＜0.05),但两组分娩成功率比较,差异无统计学意义(P＞0.05).观察组妊娠期、分娩期及产褥期并发症发生率均低于对照组,差异有统计学意义(P＜0.05).观察组新生儿并发症发生率低于对照组,差异有统计学意义(P＜0.05).两组GMS评估结果比较,差异无统计学意义(P＞0.05).研究对象在超声分级下,Ⅰ级瘢痕 60 例,Ⅱ级瘢痕 18 例,Ⅲ级瘢痕 8 例.Ⅱ级、Ⅲ级瘢痕组孕妇术中出血量及术后 24h出血量均大于Ⅰ级瘢痕组,差异有统计学意义(P＜0.05).结论:瘢痕子宫再次妊娠产妇通过阴道分娩能够有效改善产妇及新生儿结局,与再次剖宫产相比,产妇及新生儿的并发症发生率更低,产中出血量及住院时间更少,更具优势.
Abstract
Objective To explore the analysis of maternal delivery mode and impact on both pregnant women and their neonates.Methods Eighty-six pregnant women with scar uterus who were pregnant again in Shenzhen Dapeng New Area Maternal and Child Health Hospital from January 2021 to June 2023 were divided into two groups according to the mode of delivery.The control group(nude 43)underwent re-cesarean section and the observation group(nasty 43)underwent vaginal delivery.The delivery conditions(duration of labor,amount of bleeding during labor,time of hospitalization,neonatal Apgar score,success rate of delivery),incidence of complications(pregnancy,delivery and puerperium),incidence of neonatal complications,development and observation of uterine scar were compared between the two groups.Results The observation group had higher labor process time and newborn Apgar score than the control group,and lower intraoperative bleeding and hospital stay than the control group,and the difference was statistically significant(P＜0.05).However,there was no statistically significant difference in delivery success rates between the two groups(P＞0.05).The incidence of complications during pregnancy,delivery,and postpartum period in the observation group was lower than that in the control group,and the difference was statistically significant(P＜0.05).The incidence of neonatal complications in the observation group was lower than that in the control group,and the difference was statistically significant(P＜0.05).The comparison of General movements(GMS)evaluation results between the two groups showed no statistically significant difference(P＞0.05).Under ultrasound grading,there were 60 cases of grade Ⅰ scars,18 cases of grade Ⅱ scars,and 8 cases of grade Ⅲ scars in subjects of the study.The intraoperative and postoperative bleeding volume of pregnant women in the grade Ⅱ and grade Ⅲ scar groups were higher than those in the grade Ⅰ scar group,and the difference was statistically significant(P＜0.05).Conclusion The vaginal delivery can effectively improve the maternal and neonatal outcomes.Compared with the second cesarean section,the incidence of maternal and neonatal complications is lower,and the bleeding amount and hospital time is less,with more advantages.
关键词
超声/瘢痕子宫再次妊娠/分娩方式/新生儿Key words
Ultrasonography/Scar uterus:Repregnancy/Mode of delivery/Neonate引用本文复制引用
出版年
2024
NETL
NSTL
万方数据