关键词:  瘢痕, 子宫, 妊娠, 分娩, 剖宫产术

Abstract: Objective：To explore the influencing factors of delivery time and delivery mode of scarred uterus. Methods：228 cases of pregnant women with uterine cicatricial pregnancy were selected as the subjects in the department of Obstetrics and Gynecology in the People′s Hospital of Longhua District from January 2015 to December 2017, and were divided into the second cesarean section group and the vaginal delivery group according to the difference of the final delivery mode. The clinical data of two groups of pregnant women were collected and compared. Results：107 cases of pregnant women successfully completed vaginal delivery, the success rate was 46.93%, and all pregnant women had no uterine rupture. Single factor analysis showed that there were significant differences between the two groups of pregnant women in age, educational level, prenatal BMI, the time of the last cesarean section, the history of vaginal delivery, the regular antenatal examination, the use of oxytocin, the thickness of scar, the present pregnancy week and the weight of the newborn (P＜0.05). Multiple factors analysis showed that age, prenatal BMI, the distance from the last cesarean section, the history of vaginal delivery, the periodic antenatal examination, the thickness of the scar and the weight of the newborn were the influencing factors of the choice of delivery mode. Conclusions：Vaginal delivery of scar uterus is safe. Pregnant women under 35 years of age, BMI＜30 kg/m2, more than 2 years from the last cesarean section, the cicatricial thickness≥3 mm, the estimated newborn weight ＜ 2 500 g and the regular antenatal examination of the uterine cicatricial uterus should be given vaginal delivery.

Key words: Cicatrix, Uterus, Pregnancy, Parturition, Cesarean section