Singh T, Justin C W, Haloob R K
Department of Obstetrics and Gynaecology, Basildon Hospital, Essex, UK.
J Obstet Gynaecol. 2004 Feb;24(2):135-8. doi: 10.1080/01443610410001645406.
An audit of 197 patients with one previous caesarean section was undertaken over a 1-year period to determine the rates of vaginal delivery and main indications for repeat caesarean section. Trial of labour was attempted in 51.3% of women, of whom 65.3% had had a successful vaginal delivery. Vaginal birth after caesarean, however, was successful in only 33.5% of women. This low rate of vaginal birth following a previous section was due to a large number of elective caesarean sections. Maternal request was the most common indication for repeat elective caesarean section. The answer to the rising caesarean rates seems to lie in reducing the primary caesarean section rates, rigorous auditing of the unit's caesarean rates and a change in the attitude of doctors, midwives and patients towards vaginal birth after caesarean. The last might prove to be the most difficult target to achieve.
在一年时间里，对197例有过一次剖宫产史的患者进行了一项审计，以确定阴道分娩率和再次剖宫产的主要指征。51.3%的女性尝试了试产，其中65.3%成功进行了阴道分娩。然而，剖宫产术后阴道分娩仅在33.5%的女性中成功。上次剖宫产术后阴道分娩率低是由于大量选择性剖宫产。产妇要求是再次选择性剖宫产最常见的指征。剖宫产率上升的答案似乎在于降低初次剖宫产率、对单位剖宫产率进行严格审计，以及改变医生、助产士和患者对剖宫产术后阴道分娩的态度。最后一点可能是最难实现的目标。
