既往早期早产剖宫产术后再次分娩的结局

Outcome of subsequent delivery after a previous early preterm cesarean section.

作者信息

Kwee Anneke, Smink Marieke, Van Der Laar Rafli, Bruinse Hein W

机构信息

Department of Obstetrics and Gynaecology, University Medical Centre Utrecht, The Netherlands.

出版信息

J Matern Fetal Neonatal Med. 2007 Jan;20(1):33-7. doi: 10.1080/14767050601036527.

DOI:10.1080/14767050601036527

PMID:17437197

Abstract

OBJECTIVE

To determine the vaginal birth after cesarean section (VBAC) rate and risk of uterine rupture in women with a previous early preterm cesarean section.

METHODS

Women who delivered their first child by cesarean section between 26 and 34 weeks of gestation were included in a retrospective cohort study. Medical charts were reviewed for characteristics of the index pregnancy and delivery. Information of the subsequent delivery was obtained from the medical charts or from information of the attending gynecologist if the delivery was elsewhere.

RESULTS

Two hundred and forty-six women were included: 131 (53.3%) women had a subsequent pregnancy, 64 (26.0%) had no subsequent pregnancy, and from 51 (20.7%) women no information could be obtained. Of the 131 women with a subsequent pregnancy, 93 (71.0%) underwent a trial of labor (TOL) and 80 (86.0%) achieved a vaginal delivery, resulting in a VBAC rate of 61.1%. One uterine rupture occurred with favorable neonatal outcome. The uterine rupture rate for the whole cohort was 0.8% (95% CI 0.02-4.0) and for the group of women undergoing a TOL 1.1% (95% CI 0.03-5.8).

CONCLUSION

In this small series of women with a previous early preterm cesarean section the VBAC rate was high (61.1%) and the uterine rupture rate was 1.1%.

摘要

目的

确定既往有早期早产剖宫产史的女性的剖宫产术后阴道分娩（VBAC）率及子宫破裂风险。

方法

对妊娠26至34周之间首次剖宫产分娩的女性进行一项回顾性队列研究。查阅病历以了解本次妊娠及分娩的特征。如果后续分娩在其他地方进行，则从病历或主治妇科医生处获取相关信息。

结果

纳入246名女性：131名（53.3%）女性有后续妊娠，64名（26.0%）无后续妊娠，51名（20.7%）女性无法获取信息。在131名有后续妊娠的女性中，93名（71.0%）进行了引产试验（TOL）且80名（86.0%）实现了阴道分娩，VBAC率为61.1%。发生了1例子宫破裂，新生儿结局良好。整个队列的子宫破裂率为0.8%（95%CI 0.02 - 4.0），进行TOL的女性组子宫破裂率为1.1%（95%CI 0.03 - 5.8）。