21例瘢痕子宫再次妊娠分娩方式探究.doc

21例瘢痕子宫再次妊娠分娩方式探究【中图分类号】R714【文献标识码】 A【文章编号】1672-3873（2011）03-0057-02 【摘要】目的：探讨瘢痕子宫再次妊娠分娩方式的选择。方法：对我院2008年2月-2011年1月间21例瘢痕子宫再次妊娠产妇的分娩方式进行回顾性分析。结果：21例产妇中19例阴道试产分娩成功，占90.48%。产中平均出血量、产程、新生儿Apger评分与非瘢痕子宫的产妇基本相识，P0.05，无统计学意义。余2例产妇因瘢痕子宫外的原因而进行剖宫产术。结论：有剖宫产或子宫手术史的产妇再次妊娠后剖宫产并非唯一的生产方式，从而否定了“一次剖宫产，永远剖宫产”的陈旧观点。减少干预，回归自然，阴式分娩同样是瘢痕子宫再次妊娠的最佳分娩方式，但加强对产妇各项指标的评估和各种预案的研究和制定，术中应加大产妇的监测力度，以便于发现问题及早处理。 【关键词】子宫；瘢痕子宫；分娩方式 21 cases of uterine scar pregnancy and delivery means of once again Zhu Jin [Abstract] Objective: To evaluate the uterine scar pregnancy again, the choice of delivery mode. Methods: The hospital in February 2008 -2011 21 cases in January between the uterine scar pregnancy, maternal mode of delivery re-analyzed retrospectively. Results: 21 cases of 19 cases of maternal success of vaginal birth trial production, accounting for 90.48%. The average blood volume production, labor, neonatal Apger rates of maternal and non-scarred uterus basic acquaintance, P 0.05, not statistically significant. More than 2 cases of maternal uterine scar due to reasons outside the cesarean section. Conclusion: There is a history of cesarean section or uterine surgery after pregnancy, maternal re-production of cesarean section is not the only way to negate the “one cesarean section, cesarean section is always” the old point of view. Reduction intervention, return to nature, vaginal delivery is also a uterine scar pregnancy again, the best mode of delivery, enhancing the assessment of the indicators of maternal and various plans of research and development, maternal intraoperative monitoring should increase efforts to identify problems early in treatment. [Keywords]: uterus; scarred uterus; delivery methods 近十多年来，“择时剖宫产”、“经济效益性价比剖宫产”、“安全性保护剖宫产”等各种原因的干扰致使剖宫产的几率不断增高[1]。剖宫产安全、择时、经济效益性价比高，同时也避免顺产时长时间的产程观察之辛苦，满足了不同人群的各种需要。但也为许多妇女再次妊娠后分娩方式选择带来潜在的困难。以前的产科理论认为瘢痕子宫是剖宫产的绝对适应症。近年来，我院为不断的提升孕产妇管理能力和服务水平，对瘢痕子宫再次妊娠的产妇分娩方式进行“破冰”式的尝试，2008年2月-2011年1月间对21例产妇均进行阴道试产，其中，19例产妇试产成功，占90.48%。现将有关情况汇报如下