Abbassi H, el Karroumi M, Aboulfalah A, Bouhya S, Bekkay M
Maternité Lalla Meryem, CHU Ibn Rochd, Casablanca, Maroc.
J Gynecol Obstet Biol Reprod (Paris). 1998 Dec;27(8):806-10.
The mode of delivery in the parturient women with two prior cesarean is controversial. Based on a prospective analysis of 130 cases, we tried to assess the outcome of trial of labor after two cesarean sections. Among 167 patients with two uterine scars, 130 (77.8%) were selected for a trial of labor that was successful in 65 cases (50%). The overall rate of vaginal birth and cesarean section was 39% and 61%, respectively. There were 4 scar dehiscences and 2 uterine ruptures among the women who underwent trial of labor, but no case of perinatal death or morbidity related to these complications was observed. In the majority of the cases, these scar separations were due to poor obstetrical conditions. Trial of vaginal delivery after two prior cesarean sections seems to us a reasonable attitude if it is well indicated and supervised correctly.
有两次剖宫产史的产妇的分娩方式存在争议。基于对130例病例的前瞻性分析，我们试图评估两次剖宫产术后试产的结果。在167例有两个子宫瘢痕的患者中，130例（77.8%）被选择进行试产，其中65例（50%）成功。阴道分娩和剖宫产的总体发生率分别为39%和61%。在进行试产的女性中，有4例瘢痕裂开和2例子宫破裂，但未观察到与这些并发症相关的围产期死亡或发病病例。在大多数病例中，这些瘢痕分离是由于产科条件不佳所致。对我们来说，如果指征明确且监督正确，两次剖宫产术后进行阴道试产似乎是一种合理的做法。
