剖宫产术后再次妊娠阴道试产的研究进展

doi:10.12280/gjfckx.20200450

摘要/Abstract

摘要：

随着生育政策的转变,剖宫产术后再次妊娠孕妇逐渐增多。如何选择分娩方式引起了产科学界的广泛思考与讨论。既往此类孕妇推荐选择性重复剖宫产术作为终止方式,虽可规避子宫破裂风险,但其造成的母体二次损伤及较高的产后出血风险仍不可忽视。近年逐渐推广的剖宫产术后再次妊娠阴道试产及分娩在母儿预后方面展现出更高的价值。通过转变围生保健模式提高人群对剖宫产术后再次妊娠阴道试产及分娩的认识及接受度,产前准确评估孕妇的可行性条件,严格把控适应证与禁忌证,产时采取合理的辅助手段干预,可显著提高剖宫产术后再次妊娠阴道试产及分娩的安全性与成功率。为推进剖宫产术后再次妊娠阴道试产工作的开展,本文对相关文献进行分析,综述其研究进展。

关键词: 剖宫产术, 剖宫产后阴道分娩, 引产, 分娩并发症, 孕妇

Abstract:

With the change of birth policy, the number of pregnant women who are pregnant again after cesarean section is increasing. How to choose the mode of delivery has aroused wide thinking and discussion in obstetrics. In the past, this kind of pregnant women were recommended to select repeated cesarean section as the termination method. Although it can avoid the risk of uterine rupture, the secondary damage of the mother and the high risk of postpartum hemorrhage caused by it cannot be ignored. In recent years, vaginal trial delivery after cesarean section have been gradually promoted, showing higher value in maternal and child prognosis. The safety and success rate of vaginal trial delivery after cesarean section can be significantly improved by changing the perinatal health care mode, improving the awareness and acceptance of vaginal trial delivery after cesarean section, accurately evaluating the feasibility conditions of pregnant women before delivery, strictly controlling the indications and contraindications, and taking reasonable auxiliary intervention during delivery. In order to promote the work of vaginal trial delivery after cesarean section, this paper analyzes the relevant literature and summarizes the research progress.

Key words: Cesarean section, Vaginal birth after cesarean, Labor,induced, Obstetric labor complications, Pregnant women

邢宇, 陈萱. 剖宫产术后再次妊娠阴道试产的研究进展[J]. 国际妇产科学杂志, 2021, 48(1): 99-104.

XING Yu, CHEN Xuan. Research Progress of Vaginal Trial Delivery after Cesarean Section[J]. Journal of International Obstetrics and Gynecology, 2021, 48(1): 99-104.

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