高危妊娠管理在瘢痕子宫阴道分娩中的应用研究

王玉华河南省项城市中医院妇产科，河南项城　466200

高危妊娠管理在瘢痕子宫阴道分娩中的应用研究

王玉华
河南省项城市中医院妇产科，河南项城466200

目的 探讨高危妊娠管理在瘢痕子宫阴道分娩中的应用。方法 选取2012年8月—2015年11月该院接收的168例瘢痕子宫孕妇，随机分组，各84例，对照组给予常规护理，观察组给予高危妊娠管理，比较两组产妇分娩方式、分娩结局、围生儿体重、住院时间。结果 高危妊娠管理后观察组阴道试产率、试产成功率、阴道分娩率均显著高于对照组，差异有统计学意义（P＜0.05）；观察组产后2 h出血量、24 h出血量均显著低于对照组，差异有统计学意义（P＜0.05）；观察组新生儿出生体重显著低于对照组，住院天数显著低于对照组，差异有统计学意义（P＜0.05）。结论 高危妊娠管理可改变产妇分娩方式，改善瘢痕子宫产妇分娩结局，减少产妇产后出血量。

高危妊娠管理；瘢痕子宫；阴道分娩

［Abstract］Objective To study the application of high risk pregnancy management in the scarred uterus vaginal delivery. Methods 168 cases of pregnant women with scarred uterus admitted in our hospital from August 2012 to November 2015 were selected and randomly divided into two groups with 84 cases in each，the control group were given routine nursing，the observation group were given high-risk pregnancy management，and the delivery method，delivery outcome，perinatal weight and length of stay were compared between the two groups.Results After the high-risk pregnancy management，the vaginal trial production rate，success rate of trial production and vaginal birth rate in the observation group were obviously higher than those in the control group，and the differences had statistical significance，P＜0.05，the bleeding volumes after postpartum 2h and 24h in the observation group were obviously lower than those in the control group，and the differences had statistical significance，P＜0.05；the birth weight of newborns in the observation group was obviously lower than that in the control group，and the length of stay was lower than that in the control group，and the difference had statistical significance，P＜0.05.Conclusion The high-risk pregnancy management can change the delivery method of pregnant women，improve the delivery outcome of pregnant women with scarred uterus and reduce the postpartum bleeding volume.

［Key words］High-risk pregnancy management；Scarred uterus；Vaginal delivery

随着生活习惯的改变，孕妇活动量减少，加之孕妇对阴道分娩的恐惧心理，致使选择剖宫产的孕妇越来越多，使剖宫产率逐年上升［1-2］。剖宫产在一定给程度上挽救了产妇和胎儿的生命，但易引发并发症，世界卫生组织建议剖宫产率不超过15%［3］。瘢痕子宫再次采用剖宫产术易造成产妇子宫切口破裂，对产妇生命安全造成极大威胁。自然分娩可有效减少并发症的发生，提高新生儿生命质量。有研究表明［4］，对子宫瘢痕妊娠患者实施高危妊娠管理，可有效改变产妇分娩方式。该院对168例瘢痕子宫孕妇进行分组对比，以探讨高危妊娠管理在瘢痕子宫阴道分娩中的应用，现将结果报道如下。……