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华西医学  2014 

剖宫产后阴道分娩的临床观察

DOI: 10.7507/1002-0179.20140702, PP. 2322-2325

Keywords: 剖宫产,阴道分娩,产程停滞

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Abstract:

目的 研究影响剖宫产后阴道分娩成败的因素。方法 回顾性分析2012年10月-2013年7月间80例自愿要求经阴道试产的既往有剖宫产手术史的单胎孕妇资料,按照最终阴道分娩成败分为剖宫产后阴道分娩(VBAC)组(n=40)和重复剖宫产(RCS)组(n=40),对其一般资料进行比较,并作多因素相关分析。同时随机选取同时期40例既往有阴道分娩史,此次再行阴道分娩的患者作为对照组,记录VBAC组与对照组产后出血量、总产程的时间、会阴情况。结果 既往前次剖宫产指征为产程停滞OR=1.601,95%CI(1.025,2.469),P=0.04、宫颈Bishop评分<7分OR=3.757,95%CI(1.437,8.772),P=0.01及新生儿体质量大OR=1.391,95%CI(1.124,2.583),P=0.03与VBAC失败有关。VBAC组总产程时间为(6.71±2.94)h,对照组为(5.88±2.47)h,差异无统计学意义(P=0.176);VBAC组产后出血量为(259.13±75.31)mL,对照组为(230.36±67.44)mL,差异无统计学意义(P=0.076)。结论 VBAC术后恢复快,住院时间短,但需把握合适的指征以保证母婴安全。

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