Clinical analysis of 140 cases of scar pregnancy after cesarean section
140例剖宫产后疤痕子宫再次妊娠分娩方式的临床分析

摘要

目的 探析剖宫产后疤痕子宫再次妊娠分娩方式及其临床状况。方法 本研究开展的时间为2019年1月-2020年2月，便利选取在此期间我院收治的140例剖宫产后疤痕子宫再次妊娠产妇的临床资料作为主要研究对象，对所有患者的资料进行回顾性分析。比较产妇剖宫产和经阴道分娩方式后的分娩结局。另外选取同期收治的非疤痕子宫阴道分娩产妇与疤痕子宫再次妊娠分娩产妇进行比较，比较产妇的分娩结果。观察产妇的分娩状况，并对相关数据进行统计，尤其是疤痕子宫再次妊娠分娩的结局、疤痕子宫再次妊娠与非疤痕子宫阴道分娩结局等数据进行完整记录，同时将记录后的数据进行比较。结果 根据剖宫产后疤痕子宫再次妊娠产妇的资料分析得知，剖宫产后疤痕子宫再次妊娠阴道试产共计36例，其中有29例成功，成功率为80.56%，所有的产妇中有112例剖宫产，剖宫产率为80.0%；再次剖宫产产妇和阴道分娩产妇出血量分别为（421.45±92.77）ml、（201.38±48.66）ml，相比差异有统计学意义（P＜0.05）；阴道分娩产妇和再次剖宫产产妇，比较产褥病、住院天数，阴道分娩产妇相对较低，差异有统计学意义（P＜0.05）；同期收治的非疤痕子宫经阴道分娩产妇与疤痕子宫再次妊娠经阴道分娩产妇，产时出血量、产褥病率、住院天数及新生儿Apgar评分比较，无明显差异，无统计学意义（P＞0.05）。结论 在选择剖宫产后疤痕子宫再次妊娠产妇的分娩方式时，应该对经引导分娩指证进行全面掌握，同时对产程进行密切监测，在此过程中经阴道分娩的安全性高于剖宫产。

Abstract

Objective: To explore the method and clinical status of the second pregnancy and delivery of scar uterus after cesarean section.
Methods: This study was conducted from January 2019 to February 2020. It is convenient to select the clinical data of 140 cases of pregnant women with scarred uterus after cesarean section who were admitted to our hospital during this period. The data were analyzed retrospectively. Compare the delivery outcomes after maternal cesarean section and vaginal delivery. In addition, the non-scar uterine vaginal delivery women who were admitted to the same period were compared with those with scar uterine pregnancy and delivery, and the delivery results of the women were compared. Observe the delivery status of the parturient, and make statistics on the relevant data, especially the outcome of the second pregnancy of the scarred uterus, the outcome of the second pregnancy of the scarred uterus and the outcome of the vaginal delivery of the non-scarred uterus, and compare the recorded data.
Results: According to the analysis of the data of the pregnant women with scarred uterus after cesarean section, a total of 36 cases of vaginal trial with scarred uterus after cesarean section were performed, of which 29 cases were successful with a success rate of 80.56%. 112 cases of cesarean section, the rate of cesarean section was 80.0%; the amount of bleeding of the cesarean section women and vaginal delivery women were (421.45 ± 92.77) ml and (201.38 ± 48.66) ml, the difference was statistically significant (P <0.05); vaginal delivery maternal and re-cesarean delivery maternal, compared with puerperal disease, hospitalization days, vaginal delivery maternal is relatively low, the difference is statistically significant (P <0.05); non-scar uterine transvaginal delivery maternal treatment in the same period. There was no significant difference between the uterus with scarred uterus and vaginal delivery, the amount of bleeding during delivery, the rate of puerperal disease, the length of hospitalization and the apgar score of the newborn (P> 0.05).
Conclusion  : When choosing a delivery method for a pregnant woman with a scarred uterus after cesarean section, the indications for guided delivery should be fully grasped, and the birth process should be closely monitored. The safety of transvaginal delivery during this process is higher than that of cesarean section.