The Retrospective Study On The Model Of Uterine Scar Pregnancy Based On 615 Cases

Objective:Based on the high rate of cesarean section in o ur country, with the open of the second child birth policy, how to select the delivery way of scar uterus gradually highlight the problem before the obstetrician. Uterine scar is well known because of a higher risk of pregnancy and delivery again, it has b ecome obstetric risk factors, coupled with the current critical medical environment, we need to use the limited medical resources management a huge number of births, particularly maternal uterine scar pregnancy maternal natural childbirth fear and lack of confidence, health laws and regulations are not perfect, again resulting in uterine scar pregnancy cesarean delivery method is still the majority. Although many recent studies on uterine scar pregnancy and delivery mode again, but because of obstetric hosp ital for observation during treatment highly variable, reference clinical data available, there are many indications of subjective factors, in addition to various hospital equipment, medical treatment the level of good and bad, there are still a lot of debate on this issue. In view of this, the present study analyzed clinical data in January 2011 December 2013 of 615 cases of hospital delivery of maternal uterine scar retrospectively to guide clinicians to scarring of the uterus to make appropriate clinical treatment for pregnant women. Methods:615 cases of puerperal clinical patients in the hospital from January in 2011 to December in 2013 were analyzed. According to the pregnancy type,cesarean section again included 536 cases and VBAC included 79 cases. And 3470 cases of vaginal delivery were selected by compared 117 cases Uterine scar vaginal delivery, Plus 2274 cases of cesarean delivery for the first time were selected by compared 536 cases of V cesarean section again. To description of scar uterus pregnancy result and the pros and cons of the choose way of delivery. Results:(1)The main delivery way of the uterus scar were still in cesarean section again, accounted for 87.15%,VBAC accounted for 12.85% in all uterus scar, but VBAC in uterus scar accounted for 67.52%, the result of vaginal delivery was beyond satisfaction.(2)In the constitute of cesarean section indications of uterus scar pregnancy again, uterus scar was displayed in the first place, accounted for 47.20%,then followed by pregnancy-associated complications, fatal factors, obstetric complications and Difficult delivery, Incomplete uterine rupture, other factors and Aura of uterine rupture respectively accounted for 24.44%,14.37%, 4.84%,3.73%,3.37%,2.05%.(3) In the Apgar score, weight difference between the cesarean section again group and the VBAC group, difference with no significance(P> 0.05).(4) Significant difference was noted between the VBAC group and the cesarean sections again group on postpartum hemorrhage rate, the first group has the smaller postpartum hemorrhage rate(P<0.05).(5) The uterine scar vaginal delivery group has smaller chances of success ratio and natural delivery than the vaginal delivery group, significant difference was noted(P<0.05).(6) O n the episiotomy, the use of forceps and the postpartum hemorrhage between cesarean sections again group and cesarean delivery for the first time group, difference with no significance(P>0.05).(7) O n incision infection, interventional surgery and amniotic fluid between cesarean sections again group and cesarean delivery for the first time group, difference with no significance(P>0.05).(8)The cesarean sections again group has the higher risk on the uterus resection rate and the postpartum hemorrhage than the cesarean delivery for the first time group, the difference was significantly(P<0.05). Conclusions:The main delivery way of the uterus scar were still in cesarean section again, simple lines due to scar uterus still accounts for most of cesarean section indications;Uterus scar maternal increased risk of postpartum hemorrhage and hysterectomy, we should be strictly grasp the cesarean section indications for the first time, and reduce the rate of cesarean delivery;The result of the scar uterus vaginal trial production was satisfactory, we should encouraged suitable for vaginal delivery of scar uterus pregnant women to vaginal delivery. But we should be closely observed in vaginal trial production process.