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目的探讨剖宫产术后再次妊娠阴道分娩的可行性。方法选取我院产科分娩的首次采用剖宫产进行分娩的123例再次分娩孕妇为研究对象,分别进行剖宫产术后再次妊娠阴道分娩组和剖宫产术后再次妊娠剖宫产组,比较两组患者的分娩结局、母婴并发症及医疗费用等临床资料,探讨剖宫产术后再次妊娠阴道分娩的可行性。结果剖宫产组产妇在出血量、住院天数及住院费用方面明显高于阴道分娩组产妇,差异有统计学意义(t=20.692,P<0.05;t=37.154,P<0.05;t=380.755,P<0.05),而在新生儿窒息、宫颈裂伤、产后出血方面则差异无统计学意义(P>0.05),无子宫破裂。结论剖宫产手术史并非再次剖宫产的绝对指征,在严密监护下,无阴道分娩禁忌的剖宫产史孕妇可优先考虑阴道试产。在设备及技术力量有保证的医院,只要有试产条件,阴道分娩不失为一种安全、有效、经济的分娩方式。
Objective To investigate the feasibility of vaginal delivery after cesarean section. Methods 123 cases of second delivery pregnant women who were delivered by cesarean section in our hospital for obstetric delivery were enrolled in this study. The vaginal delivery group after cesarean section and the cesarean section again after cesarean section were compared. Two groups of patients with childbirth outcomes, maternal and child complications and medical costs and other clinical data to explore the feasibility of vaginal delivery after cesarean pregnancy again. Results Maternal cesarean section group was significantly higher than that of vaginal delivery group in the amount of bleeding, length of hospital stay and hospitalization (t = 20.692, P <0.05; t = 37.154, P <0.05; t = 380.755, P <0.05), but there was no significant difference in neonatal asphyxia, cervical laceration and postpartum hemorrhage (P> 0.05), no uterine rupture. Conclusion The history of cesarean section is not an absolute indication of cesarean section. Under strict supervision, pregnant women with a history of cesarean section without vaginal birth contraception may give priority to vaginal trial production. In hospitals with guaranteed equipment and technical strength, vaginal delivery is a safe, effective and economical mode of delivery as long as there are pilot production conditions.