Coutty N, Deruelle P, Delahousse G, Le Goueff F, Subtil D
Clinique d'obstétrique, hôpital Jeanne-de-Flandre, CHRU de Lille, 1, rue Eugène-Avinée, 59037 Lille, France.
Gynecol Obstet Fertil. 2004 Oct;32(10):855-9. doi: 10.1016/j.gyobfe.2004.08.013.
To determine if a trial of labor in twin pregnancy with previous cesarean section is an acceptable alternative to systematic cesarean section.
Based on a retrospective and comparative study from 1st January 1996 to 30th June 2003 in Maternite Jeanne-de-Flandre (Lille) and Pavillon Paul-Gelle (Roubaix), 35 trials of labor in twin pregnancies with previous cesarean section have been compared with 35 twin gestations attempting vaginal delivery without a prior cesarean. This comparative study has been led by sorting out the patients according to their gestational age, parity and maternity.
Twenty-seven women (77%) delivered vaginally and eight (23%) by elective caesarean section. Postpartum hemorrhage was more frequent for caesarean section (75%). No scare dehiscence or rupture occurred. There was not any haemostasis hysterectomy or embolisation related to postpartum haemorrhage. Neonatal outcome was similar in both groups.
Twin trial of labor after a previous cesarean section seems to be a safe alternative to routine repeat cesarean delivery as maternal and fetal morbidity and mortality are safe.
确定既往有剖宫产史的双胎妊娠进行引产是否是系统性剖宫产的可接受替代方案。
基于1996年1月1日至2003年6月30日在里尔的珍妮 - 德 - 弗朗德妇产医院和鲁贝的保罗 - 盖勒大楼进行的一项回顾性比较研究，将35例既往有剖宫产史的双胎妊娠引产病例与35例未行剖宫产而尝试经阴道分娩的双胎妊娠病例进行了比较。这项比较研究通过根据患者的孕周、产次和分娩情况对患者进行分类来开展。
27名女性（77%）经阴道分娩，8名（23%）接受择期剖宫产。剖宫产产后出血更为常见（75%）。未发生瘢痕裂开或破裂。未出现与产后出血相关的止血性子宫切除术或栓塞术。两组的新生儿结局相似。
既往有剖宫产史的双胎妊娠引产似乎是常规再次剖宫产的安全替代方案，因为母婴发病率和死亡率均处于安全范围。
