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剖宫产后再次妊娠分娩方式探讨 |
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张丽江 王山米 屠铮
摘 要：目的 探讨剖宫产后再次妊娠的分娩方式。方法 对66例剖宫产后再次妊娠产妇分娩方式进行回顾性分析。结果 阴道试产11例(16.7%)，其中顺产8例，产钳及臀牵引各1例，试产成功率为90.9%，总产程8小时39分。再次剖宫产56例(84.8%)，有产科指征者27例，患者及家属要求手术加绝育者9例，子宫瘢痕及珍贵胎儿手术者20例。本次妊娠可阴道试产者39例，试产率为28.2%。结论 剖宫产史作为再次剖宫产的指征是不合理的，如无产科指征，应予试产机会，因为阴道分娩可减少再次开腹手术给患者带来的各种危险和并发症，减少患者的手术痛苦和经济负担，减少住院时间，可提高床位周转，缓解医院床位紧张状况等，应予提倡。
关键词：剖宫产 再次妊娠 分娩方式
Discussion on mode of delivery of repregnancy following cesarean section
Zhang Lijiang
(Department of Obstetrics and Gynecology,People's Hospital,Beijing Medical University,Beijing 100044)
Wang Shanmi
(Department of Obstetrics and Gynecology,People's Hospital,Beijing Medical University,Beijing 100044)
Tu Zheng
(Department of Obstetrics and Gynecology,People's Hospital,Beijing Medical University,Beijing 100044)
Abstract：Objective Discussing the mode of delivery of repregnancy following cesarean section.Methods Sixty-six cases of repregnant women with previons cesarean section were analyzed retrospectively on mode of delivery.Results Eleven of all cases (16.7%) were allowed trial of vaginal labour,eight spontaneous vaginal deliveries,one forceps delivery and one assisted breech delivery,and the rate of successful labour was 90.9%.The average total time of delivery was eight hours and fifty-six cases (84.8%) of repeat C.S among whom twenty-seven had absolute indication,nine patients and their relatives insisted on repeat C.S and sterilization.The indication of another twenty was uterine scar and precious fetus.Thirty-nine cases may have a trial of vaginal labour,but the trial labour rate was only 28.2%.Conclusion It is unreasonable for the cesarean section history as the index of C.S.We should try the vaginal delivery,which may reduce risks and complications,relieve patients of operative pain and economic burden,shorten hospital stay and made words used more efficient,should be recommended.
Key words：Cesarean section Repregnancy [1] [2] [3] 下一页
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