妇产与遗传（电子版）
婦產與遺傳（電子版）
부산여유전（전자판）
Obstetrics-Gynecology and Genetics(Electronic Edition)
2014年
1期
30-32
,共3页
剖宫产术后再次妊娠%分娩方式%并发症
剖宮產術後再次妊娠%分娩方式%併髮癥
부궁산술후재차임신%분면방식%병발증
pregnant after cesarean section%delivery method%complications
目的：探讨剖宫产术后再次妊娠的分娩方式。方法回顾分析2012年1月到2012年12月云南省邵通市第一人民医院住院分娩的330例剖宫产术后再次妊娠孕妇的分娩方式及结局，其中经阴道试产组58例，剖宫产组272例。结果剖宫产术后再次妊娠330例孕妇中经阴道试产58例，成功经阴道分娩32例，失败26例，其中发生子宫先兆破裂改剖宫产3例，顺产死胎2例，子宫破裂致死胎1例，子宫破裂发生率1.7%；产后出血100~800ml，平均（300±50）ml；新生儿结局良好。剖宫产组272例，产后出血500~3000ml，平均（600±100）ml，因宫缩乏力行子宫切除1例，术中发现子宫不全破裂7例。结论剖宫产后通过认真评估可以进行阴道试产；加强产时监护，产妇和胎儿一旦发生危急症立即剖宫产结束分娩。
目的：探討剖宮產術後再次妊娠的分娩方式。方法迴顧分析2012年1月到2012年12月雲南省邵通市第一人民醫院住院分娩的330例剖宮產術後再次妊娠孕婦的分娩方式及結跼，其中經陰道試產組58例，剖宮產組272例。結果剖宮產術後再次妊娠330例孕婦中經陰道試產58例，成功經陰道分娩32例，失敗26例，其中髮生子宮先兆破裂改剖宮產3例，順產死胎2例，子宮破裂緻死胎1例，子宮破裂髮生率1.7%；產後齣血100~800ml，平均（300±50）ml；新生兒結跼良好。剖宮產組272例，產後齣血500~3000ml，平均（600±100）ml，因宮縮乏力行子宮切除1例，術中髮現子宮不全破裂7例。結論剖宮產後通過認真評估可以進行陰道試產；加彊產時鑑護，產婦和胎兒一旦髮生危急癥立即剖宮產結束分娩。
목적：탐토부궁산술후재차임신적분면방식。방법회고분석2012년1월도2012년12월운남성소통시제일인민의원주원분면적330례부궁산술후재차임신잉부적분면방식급결국，기중경음도시산조58례，부궁산조272례。결과부궁산술후재차임신330례잉부중경음도시산58례，성공경음도분면32례，실패26례，기중발생자궁선조파렬개부궁산3례，순산사태2례，자궁파렬치사태1례，자궁파렬발생솔1.7%；산후출혈100~800ml，평균（300±50）ml；신생인결국량호。부궁산조272례，산후출혈500~3000ml，평균（600±100）ml，인궁축핍역행자궁절제1례，술중발현자궁불전파렬7례。결론부궁산후통과인진평고가이진행음도시산；가강산시감호，산부화태인일단발생위급증립즉부궁산결속분면。
Objective To study the deliverymode of re-pregnancy after cesarean section. Method Retrospectively analyzed the delivery methods and the results of 330 re-pregnant women after cesarean section who were in hospital from January to December, 2012, all the re-pregnant women were divided into 2 groups:58 women were in vaginal birth after cesarean section group, 272 were in cesarean section group. Results Among 330 cases, 58 cases were tried to deliver through vagina, 32 succeeded and 26 failed, 3 were changed to cesarean section because of aura uterine rupture, 2 delivered stillbirth and 1 delivered stillbirth with uterine rupture in the course of delivery, the incidence of uterine rupture was 1.7%. The postpartum hemorrhage was 100~800ml and(300 ± 50)ml in average, and achieved good neonatal outcomes. 272 cases were delivered by cesarean section, the postpartum hemorrhage was 500~3000ml and (600 ± 100)ml in average, 1 case were conducted hysterectomy due to uterine inertia, 7 cases occurred incomplete uterine rupture during delivery. Conclusions The re-pregnant women pregnant after cesarean section can try to deliver through vagina after sufficient valuation by obstetrician. We should reinforce childbearing monitoring and the moment when the re-pregnant woman and the fetus are in danger, the vaginal delivery should stop and immediately operate cesarean section to end the delivery course.
