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剖腹產(chǎn)后生二胎 子宮破裂母嬰死亡(3)

出處：媽媽育兒網(wǎng) 日期：2015-10-01 20:09:12 編輯：Chen

專家權(quán)威解答：

全球范圍內(nèi)的剖宮產(chǎn)都在上升，目前全國(guó)城鄉(xiāng)統(tǒng)一放開(kāi)"單獨(dú)二胎"，越來(lái)越多的人將再次生育。第一次是剖宮產(chǎn)，第二次的分娩方式不能一概而論。

第一次剖腹產(chǎn)之后，如果第二次選擇了自然分娩，會(huì)降低新生兒出生后呼吸系統(tǒng)疾病的發(fā)生風(fēng)險(xiǎn)，也會(huì)降低再次妊娠發(fā)生嚴(yán)重并發(fā)癥如前置胎盤(pán)，胎盤(pán)植入的風(fēng)險(xiǎn)。但它同時(shí)會(huì)增加圍產(chǎn)兒死亡風(fēng)險(xiǎn)和新生兒缺血缺氧性腦病的可能。所以，嚴(yán)格掌握剖宮產(chǎn)術(shù)后再次妊娠陰道分娩的適應(yīng)癥及禁忌癥顯得尤為重要。

如果滿足以下條件，在首次剖腹產(chǎn)后，二胎可以考慮順產(chǎn)：

1.前次剖宮產(chǎn)為子宮下段橫切口的剖宮產(chǎn)。

2.B超檢查提示子宮下段延續(xù)好。瘢痕厚度≥3㎝。

3.分娩間隔≥2年。

4.前次剖宮產(chǎn)指征不復(fù)存在，亦未出現(xiàn)新的手術(shù)指征。

5.宮頸Bishop評(píng)分≥6分，無(wú)相對(duì)頭盆不稱6.具有較好的醫(yī)療監(jiān)護(hù)設(shè)備，能隨時(shí)手術(shù)。新生兒科，具備輸血和搶救條件。

綜上所述，二胎分娩方式要注意個(gè)體化處理原則，需要產(chǎn)科醫(yī)師和孕婦家屬充分討論評(píng)估，取得一致意見(jiàn)。

本文由媽媽育兒網(wǎng)（http://m.15thirdstreetblackrock.com/）小編編輯整理

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