剖宫产术后再次妊娠阴道分娩产程的分析及护理(1)
[摘要] 目的 探究經剖宫产术再次妊娠并阴道试产的产程观察及护理效果。方法 回顾性方便选取2016年12月—2018年3月于该院剖宫产术后再次妊娠并进行阴道试产的60例产妇作为观察对象，观察其阴道试产结局、出血情况、瘢痕厚度、产程以及试产成功、失败的相关因素。结果60例产妇中阴道试产成功的有46例，试产失败的有14例。阴道试产成功产妇中，瘢痕厚度≥1.5 mm且≤2.5 mm的人数占比最高;阴道试产成功组的住院天数为(2.86±0.35)d，失败组为(5.87±1.21)d，成功组的初次哺乳时间为(1.24±0.35)d，失败组的初次哺乳时间为(2.67±0.32)d，成功组的住院天数与初次哺乳时间均明显短于失败组(t=8.51、4.40，P<0.05);试产成功组的住院费用为(4 326.36±23.36)元，失败组为(8 647.54±26.72)元，试产成功组的住院费用明显少于失败组(t=183.0，P<0.05);试产成功组的新生儿体重为(3.22±0.12)kg，失败组为(3.51±0.10)kg，成功组新生儿体重显著轻于试产失败组(t=2.39，P<0.05)，但产妇年龄、孕周、产后出血量、新生儿Apgar评分、瘢痕厚度以及上次剖宫产间隔均差异无统计学意义(P>0.05)。结论 对剖宫产术后再次妊娠阴道分娩的产妇进行全面的产前评估、产前健康宣教，分娩时采用全程连续性助产护理，分娩后进行严密的监护可以显著提升剖宫产术后阴道试产的成功率，保障母婴生命健康。
[关键词] 剖宫产术;再次妊娠;阴道分娩;产程;观察;护理
[中图分类号] R473 [文献标识码] A [文章编号] 1674-0742(2019)07(c)-0127-03
Analysis and Nursing of Vaginal Delivery after Re-pregnancy after Cesarean Section
LIAO Wen-mei， FANG Hai-qin
Yancheng Maternal and Child Health Hospital， Yancheng， Jiangsu Province， 224000 China
[Abstract] Objective To investigate the observation and nursing effect of cesarean section re-pregnancy and vaginal trial production. Methods A retrospective selection of 60 pregnant women who underwent cesarean section and vaginal trials in our hospital from December 2016 to March 2018 was conveniently selected as an observation object to observe the outcomes of vaginal trial production， bleeding， scar thickness， labor process， and factors related to the success and failure of trial production. Results Of the 60 cases of maternal vaginal trials， 46 cases were successful， and 14 cases of the trials failed. Among the successful vaginal trials， the number of people with scar thickness ≥1.5 mm and ≤2.5 mm was the highest; the number of hospital stays in the successful vaginal trial group was (2.86±0.35) d， and the failure group was (5.87±1.21) d， the first time in the successful group of the breastfeeding time was (1.24±0.35) d， and the initial breastfeeding time in the failed group was (2.67±0.32) d. The hospitalization days and the initial breastfeeding time in the successful group were significantly shorter than the failure group (t=8.51， 4.40， P<0.05). The hospitalization cost of the successful trial production group was (4 326.36±23.36) yuan， and the failure group was (8 647.54±26.72) yuan. The hospitalization expenses of the successful trial production group were significantly less than the failure group (t=183.0， P<0.05); trial production of the weight of newborns in the successful group was (3.22±0.12)kg， and that in the failure group was (3.51±0.10) kg. The weight of the newborns in the successful group was significantly lighter than that in the trial production failure group (t=2.39， P<0.05)， but the maternal age， There was no statistically significant difference in gestational age， postpartum hemorrhage， neonatal Apgar score， scar thickness and interval between the last cesarean section (P>0.05). Conclusion Comprehensive prenatal evaluation， prenatal health education， and full-time continuous midwifery care for women who have had vaginal delivery after cesarean section. Strict monitoring during delivery can significantly improve the vaginal delivery after cesarean section. The success rate of trial production guarantees the health of mothers and children., 百拇医药(廖文梅 方海琴)
[关键词] 剖宫产术;再次妊娠;阴道分娩;产程;观察;护理
[中图分类号] R473 [文献标识码] A [文章编号] 1674-0742(2019)07(c)-0127-03
Analysis and Nursing of Vaginal Delivery after Re-pregnancy after Cesarean Section
LIAO Wen-mei， FANG Hai-qin
Yancheng Maternal and Child Health Hospital， Yancheng， Jiangsu Province， 224000 China
[Abstract] Objective To investigate the observation and nursing effect of cesarean section re-pregnancy and vaginal trial production. Methods A retrospective selection of 60 pregnant women who underwent cesarean section and vaginal trials in our hospital from December 2016 to March 2018 was conveniently selected as an observation object to observe the outcomes of vaginal trial production， bleeding， scar thickness， labor process， and factors related to the success and failure of trial production. Results Of the 60 cases of maternal vaginal trials， 46 cases were successful， and 14 cases of the trials failed. Among the successful vaginal trials， the number of people with scar thickness ≥1.5 mm and ≤2.5 mm was the highest; the number of hospital stays in the successful vaginal trial group was (2.86±0.35) d， and the failure group was (5.87±1.21) d， the first time in the successful group of the breastfeeding time was (1.24±0.35) d， and the initial breastfeeding time in the failed group was (2.67±0.32) d. The hospitalization days and the initial breastfeeding time in the successful group were significantly shorter than the failure group (t=8.51， 4.40， P<0.05). The hospitalization cost of the successful trial production group was (4 326.36±23.36) yuan， and the failure group was (8 647.54±26.72) yuan. The hospitalization expenses of the successful trial production group were significantly less than the failure group (t=183.0， P<0.05); trial production of the weight of newborns in the successful group was (3.22±0.12)kg， and that in the failure group was (3.51±0.10) kg. The weight of the newborns in the successful group was significantly lighter than that in the trial production failure group (t=2.39， P<0.05)， but the maternal age， There was no statistically significant difference in gestational age， postpartum hemorrhage， neonatal Apgar score， scar thickness and interval between the last cesarean section (P>0.05). Conclusion Comprehensive prenatal evaluation， prenatal health education， and full-time continuous midwifery care for women who have had vaginal delivery after cesarean section. Strict monitoring during delivery can significantly improve the vaginal delivery after cesarean section. The success rate of trial production guarantees the health of mothers and children., 百拇医药(廖文梅 方海琴)