Agarwal Anjoo, Chowdhary Poonam, Das Vinita, Srivastava Aarti, Pandey Amita, Sahu Meenakshi T
Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow (UP), India.
J Obstet Gynaecol Res. 2007 Oct;33(5):651-4. doi: 10.1111/j.1447-0756.2007.00627.x.
Management of post cesarean pregnancy continues to be a dilemma. The present study was undertaken to evaluate the outcome of such pregnancies in a resource constrained setting so that an appropriate management protocol can be decided.
An observational study was conducted in the Department Of Obstetrics And Gynecology, King George's Medical University, Lucknow, India. The outcome of all of the women admitted with pregnancy with a previous cesarean section was noted.
A total number of 447 women with a post cesarean pregnancy underwent delivery. These comprised 13.7% of total deliveries over the same period. 124 women (27.7%) had successful vaginal delivery while 323 (72.3%) had a repeat cesarean section. Maternal morbidity and perinatal mortality were both significantly higher in the vaginal delivery group (P = 0.00211 and P = 0.0426, respectively).
Vaginal birth after cesarean (VBAC) is associated with higher maternal morbidity and perinatal mortality. Therefore the decision for VBAC must be taken only after proper consideration and counseling of the couple.
剖宫产术后妊娠的管理仍然是一个难题。本研究旨在评估在资源有限的情况下此类妊娠的结局，以便确定合适的管理方案。
在印度勒克瑙乔治国王医科大学妇产科进行了一项观察性研究。记录了所有因既往剖宫产术后妊娠而入院的妇女的结局。
共有447例剖宫产术后妊娠的妇女分娩。这些妇女占同期分娩总数的13.7%。124名妇女（27.7%）成功阴道分娩，323名妇女（72.3%）接受了再次剖宫产。阴道分娩组的孕产妇发病率和围产儿死亡率均显著更高（分别为P = 0.00211和P = 0.0426）。
剖宫产术后阴道分娩（VBAC）与较高的孕产妇发病率和围产儿死亡率相关。因此，必须在对夫妇进行适当的考虑和咨询后，才能做出VBAC的决定。
