剖宫产后妊娠子宫瘢痕性阴道分娩的高危因素分析

IF 0.1 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL
R. Ye, Weixia Wang, J. Li
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引用次数: 0

摘要

这项工作的目的是分析先前剖宫产后瘢痕子宫的后续妊娠阴道分娩试验中并发症的高危因素。选择2016年2月至2019年3月入住我院产科的136名有剖宫产史的瘢痕子宫孕妇,根据妊娠和分娩阴道分娩试验结果,分为成功组和失败组。收集分娩前、分娩中、分娩后的一般数据,采用逻辑回归分析法分析瘢痕子宫阴道分娩失败的高危因素。136例患者中,108例(79.41%)阴道试验成功,28例(20.59%)阴道试验顺利。单因素分析显示,妊娠、产次和既往剖宫产、阴道出生史、产前BMI、子宫收缩、胎龄、婴儿体重、宫颈撕裂、宫颈Bishop评分、胎头高度、下子宫厚度、,Logistic回归分析显示阴道出生史,产前BMI≥30kg/m2,产次≥2次,剖宫产<2次,宫颈扩张≥1cm,胎头高度≥-3,瘢痕子宫再次阴道试产并发症的高危因素为胎膜早破和下子宫厚度3.0~3.9cm(P<0.05)。瘢痕子宫孕妇阴道分娩是可行的,但许多相关因素会影响试产失败。要重视临床检查的各个方面,严格根据适应症选择用药。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of high risk factors for complications in the trial of vaginal delivery due to uterine scarring in a subsequent pregnancy to a cesarean section.
The purpose of this work was to analyze the high-risk factors of com-plications in the trial of vaginal delivery of a subsequent pregnancy for scar uterus after a previous cesarean. 136 pregnant women with scar uterus with a history of cesarean who were admitted to our obstetrics department from February 2016 to March 2019 were selected and were divided into a successful group and a failed group according to the results of pregnancy and trial of labor vaginal delivery. Gen-eral data of before, during, and after delivery were collected and the high-risk fac-tors for failed vaginal delivery of scar uterine were analyzed by the logistic regression analysis.Among the 136 patients, 108 cases (79.41%) of vaginal trials were success-ful, and 28 cases (20.59%) of vaginal trials faired.The univariate analysis showed that the differences in gravidity, parity and the previous cesarean interval, vaginal birth history, prenatal BMI, uterine contraction, gestational age, infant weight, dila-tation of the cervix, cervical Bishop score, the height of the fetal head, the thickness of the lower uterus, and whether the membranes were prematurely ruptured were statistically significant (P<0.05). Logistic regression analysis showed vaginal birth history, prenatal BMI ≥ 30 kg/m2, parity ≥ 2 times, cesarean interval <2 times, dilatation of cervix ≥ 1 cm, the height of the fetal head ≥ -3, premature rupture of the membrane and the thickness of the lower uterus of 3.0 to 3.9 cm were the high-risk factors of complications in the vaginal trial delivery of pregnancy again for scar uterus (P<0.05). It is feasible for pregnant women with scar uterus to undergo vaginal delivery, but many related factors can affect the failure of trial of labor. It is necessary to pay attention to all aspects of clinical examination and choose applica-tions strictly according to the indications.
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来源期刊
Investigacion clinica
Investigacion clinica MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
0.20
自引率
50.00%
发文量
2
审稿时长
>12 weeks
期刊介绍: Estudios humanos, animales y de laboratorio relacionados con la investigación clínica y asuntos conexos.
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