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高齡疤痕子宮孕婦經陰道分娩安全性分析
Safety analysis of VBAC in women with advanced age
摘要
目的：從圍產期結局，分析剖腹產後陰道生產（Vaginal birth after cesarean, VBAC）用於高齡產婦的安全性。方法：收集2016年9月～2020年4月，在本院住院分娩的VBAC產婦190例（分娩孕週≥28週，既往1次剖宮產史）。按照分娩年齡分為低齡組（<35歲，105例）與高齡組（≥35歲，85例），對兩組孕產婦的圍產期結局進行比較分析。結果：兩組產婦在孕週、住院時間、身高、妊娠期糖尿病者的比例、早產率、妊娠合併甲狀腺功能減退症比例、產後出血量、產後出血率、第二產程、新生兒出生體重等方面上的差異均無統計學意義（P>0.05）。兩組產婦的貧血率及前次剖宮產距本次妊娠間隔的時間存在差異（P<0.05）。兩組產婦孕期均無出現妊娠期高血壓疾病，均無子宮破裂病例發生，且新生兒5分鐘Apgar評分均>7分，未觀察到出現新生兒窒息的情況。結論：對於既往有1次剖宮產史、單胎的高齡孕婦，VBAC是可供選擇的安全可行的分娩方式。
並列摘要
Objective: To analyze the safety of VBAC by evaluation of the perinatal outcomes of women with advanced age . Methods: 190 VBAC cases of singleton pregnancy (gestational age≥28 weeks) in Kiang Wu Hospital from September 2016 to April 2020 were studied retrospectively. The cases were divided into the "Aged group" (≥ 35-year-old, 105 cases) and the "Young group" (< 35-year-old, 85 cases). The perinatal outcomes between the two groups were compared. Results: There were no significant differences in gestational age; time of hospitalization; height; the occurrence rate of gestational diabetes mellitus, premature delivery, gestational hypothyroidism, postpartum blood loss, postpartum hemorrhage; the time of the second stage of labor and neonatal birth weight between the two groups (P>0.05). In contrast, the pregnancy interval time was longer in the "Aged group," and the rate of gestational anemia was higher in the "Young group" (P<0.05). There was no uterine rupture or gestational hypertension happened in either group. All neonatal 5 min Apgar score was >7, and no neonatal asphyxia happened. Conclusion: VABC is a safe and feasible delivery method for singleton pregnancy after one prior cesarean section in women of advanced age.