|
|
|
| Investigation and Analysis of the Influencing Factors for Delivery Mode Selection in Pregnant Women with Scarred Uterus after Cesarean Section |
| XIONG Hai-yan, ZHONG Min, FU Zhao-xia,et al |
| Department of Gynaecology and Obstetrics, People's Hospital of Longhua District of Shenzhen City affiliated to Southern Medical University,Guangdong Shenzhen 518109, China |
|
|
|
|
Abstract 【Objective】To understand the influencing factors of delivery mode selection in pregnant women with scarred uterus after cesarean section. 【Methods】The pregnant women with scarred uterus after cesarean section and their family members, and medical staff in the Department of Obstetrics and Gynecology from 10 hospitals in Shenzhen were selected as the research subjects during January to December,2016. The awareness of delivery modes ( natural labor and cesarean section) for pregnant women with scarred uterus and their family members and the knowledge of vaginal birth after cesarean section(VBAC)for medical staff were surveyed by questionnaire. The influencing factors of delivery mode selection for pregnant women with scarred uterus were analyzed by Logistic regression . 【Results】Among 993 pregnant women who chose VBAC for baby delivery, 648 cases were successful(65.25%). It was obviously much higher than pregnant women with repeated cesarean section(11.01%,χ2=31.22,P=0.000).Many factors such as living place of pregnant women, awareness of natural labor and cesarean section,tension about natural labor,previous history of vaginal delivery, and family members' suggestion for vaginal delivery had influence on the delivery mode selection(all P＜0.05).In the 738 effective questionnaires, the awareness rate of vaginal delivery by doctors was 61.65% (328/532), which was significantly higher than that of nurses (21.19%, 50/236). The difference was statistically significant (χ2=93.37,P=0.000).The awareness degree of VBAC by medical staff from tertiary hospitals was 68.46%,which was obviously higher than those from secondary (46.62%) and primary hospitals (20.69%); the difference was statistically significant(χ2=45.26,P=0.000).Furthermore, the VBAC awareness degree of medical staff in specialized hospitals was higher than that of general hospitals(P＜0.05);and the awareness degree of medical staff with senior professional title was higher than those of medical staff with junior and intermediate titles(P=0.000). 【Conclusion】The delivery mode selection of pregnant women with scarred uterus after cesarean section is made by the awareness of vaginal birth after cesarean section. It is necessary to strengthen the publicity of this knowledge.
|
|
Received: 31 March 2017
|
|
|
|
|
|
[1] Lumbiganon P, Laopaiboon M, Gülmezoglu AM, et al. Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-2008[J]. Lancet,2010,375(9713):490-499.
[2] 朱艳槐.孕妇孕期实施健康教育对降低无医学指征剖宫产率的影响[J].实用预防医学,2010,17(6):1236-1237.
[3] 侯磊,李光辉,邹丽霞,等.全国剖宫产率及剖宫产指征构成比调查的多中心研究[J].中华妇产科杂志,2014,49(10):728-735.
[4] 李博雅,杨慧霞.剖宫产后阴道分娩相关问题[J].中国实用妇科与产科杂志,2016,32(8):45-50.
[5] 张秋实,曹宇,王访,等.江苏省三级医院孕产妇选择分娩方式影响因素的调查与分析[J].全科护理,2016,14(35):3673-3675.
[6] Mardy AH,Ananth CV,Grobman WA,et al. A prediction model of vaginal birth after cesarean in the preterm period[J]. Am J Obstet Gynecol,2016,215(4):513.
[7] Villot A,Cheret-Benoist A,Creveuil C,et al. Is vaginal delivery possible for patients with myomectomy Results of a monocentric study[J]. Gynecol Obstet Fertil,2015,43(7-8):496-501.
[8] 郑清云.剖宫产术后瘢痕子宫产妇再次妊娠分娩方式探讨[J]. 河南医学研究,2016,25(3):535.
[9] 陈娟.剖宫产术后再次妊娠妇女子宫瘢痕状态及分娩方式的选择[J].药物与人,2015,28(1):101-102.
[10] 彭凯欣,赵菲.瘢痕子宫妊娠分娩时机及分娩方式选择分析[J]. 当代医学,2016,22(15):47-48. |
|
|
|
2017, Vol. 34 
