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目的探讨剖宫产术后再次妊娠的分娩方式。方法对我院432例剖宫产术后再次妊娠孕妇的分娩方式、结局及母婴并发症进行回顾性分析。并将其中再次剖宫产(RCS)292例与随机抽取同期首次剖宫产(PCS)292例进行对照,将其中剖宫产术后阴道分娩(VBAC)140例与随机抽取同期非瘢痕子宫阴道分娩(VBNC)140例进行对照。结果 VBAC组新生儿窒息、产后出血量、先兆子宫破裂发生率与对照组比较,差异无统计学意义。RCS组较VBAC组产后出血量高,平均住院天数多,经济费用高。RCS组产后出血率较PCS组高,差异有统计学意义。结论剖宫产并非是剖宫产术后再次妊娠分娩的绝对指征,符合试产条件者在严密监护下阴道试产是安全可行的。
Objective To investigate the mode of delivery after cesarean section. Methods 432 cases of cesarean section in our hospital pregnant women after cesarean delivery method, outcome and maternal and child complications were retrospectively analyzed. 292 RCS cases were compared with 292 cases of the first cesarean section (PCS) randomly selected at the same period. One hundred and forty cases of postpartum vaginal delivery (VBAC) after cesarean section were randomly divided into two groups: non-scarring uterine vagina Childbirth (VBNC) 140 cases were controlled. Results The incidence of neonatal asphyxia, postpartum hemorrhage and threatened uterine rupture in VBAC group were not significantly different from those in control group. The RCS group had a higher amount of postpartum hemorrhage, more average days of hospitalization and higher economic cost than the VBAC group. Postpartum hemorrhage rate in RCS group was higher than that in PCS group, the difference was statistically significant. Conclusion Cesarean section is not an absolute indication of second trimester pregnancy after cesarean section. It is safe and feasible for vaginal trial to be performed under the strict supervision of trial.