瘢痕子宫再次妊娠产妇经阴道分娩试产失败因素分析

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Abstract Objective To analyze the failure factors of vaginal delivery in women with re-pregnancy with scar uterus. Methods The clinical data of 246 pregnant women with a history of cesarean scar uterus who gave birth in Huaibei Maternal and Child Health Hospital of Anhui Province from December 2018 to April 2021 were retrospectively analyzed. The results of trial production through vaginal delivery were counted and divided into a successful trial production group (198 cases) and a trial production failure group (48 cases). The clinical data of puerperae of the two groups were compared, the influencing factors of the failure of vaginal delivery in women with re-pregnancy with scar uterus were explored, and the predictive value of the failure of trial of vaginal delivery in women with re-pregnancy with scar uterus was evaluated. Results In this study, the failure rate of vaginal delivery in women with re-pregnancy with scar uterus was 19.51%. Body mass index (BMI) before labor and the proportions of pregnancy complications in the failed trial production group were higher than those in the successful trial production group, and the differences were statistically significant (P ＜ 0.05). The thickness of the lower uterine segment myometrium and the Bishop score of the cervix before labor in the failed trial production group were lower than those in the successful trial production group, and the differences were statistically significant (P ＜ 0.05). The results of logistic regression analysis showed that BMI before labor, thickness of lower uterine segment myometrium, and Bishop score of cervix before labor were the related factors affecting the failure of vaginal delivery in women with re-pregnancy with scar uterus (OR = 3.688, 2.878, 3.983, P ＜ 0.05). ROC curve analysis showed that the best cut-off points of pre-partum BMI, lower uterine segment myometrial thickness and Bishop score of the cervix before labur for predicting the failure of vaginal delivery in women with re-pregnancy with scar uterus were 27.85 kg/m2, 2.21 mm, and 6.92 points, respectively; whie the AUCs were 0.619, 0.733, and 0.777, respectively. Conclusion Pre-labor BMI, lower uterine segment myometrial thickness and pre-labor cervix Bishop score can be used as important reference indicators for predicting the failure of vaginal delivery in these patients.

Key words： Scar uterus Re-pregnancy Vaginal delivery Cesarean section

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	LI Yi JIN Xinglin JIANG Yufen

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LI Yi JIN Xinglin JIANG Yufen. Analysis of failure factors of vaginal delivery in women with re-pregnancy with scar uterus[J]. 中国医药导报, 2022, 19(14): 28-31.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2022/V19/I14/28

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