剖宫产术后阴道分娩
Vaginal birth after cesarean section.
作者信息
Bangal Vidyadhar B, Giri Purushottam A, Shinde Kunaal K, Gavhane Satyajit P
机构信息
Department of Obstetrics and Gynaecology, Rural Medical College and Pravara Rural Hospital of Pravara Institute of Medical Sciences, (Deemed University) Loni, Maharashtra, India.
出版信息
N Am J Med Sci. 2013 Feb;5(2):140-4. doi: 10.4103/1947-2714.107537.
BACKGROUND
The rate of primary cesarean section (CS) is on the rise. More and more women report with a history of a previous CS. A trial of vaginal delivery can save these women from the risk of repeat CS.
AIMS
The study was conducted to assess the safety and success rate of vaginal birth after CS (VBAC) in selected cases of one previous lower segment CS (LSCS).
MATERIALS AND METHODS
The prospective observational study was carried out in a tertiary care teaching hospital over a period of two years. One hundred pregnant women with a history of one previous LSCS were enrolled in the study.
RESULTS
In the present study, 85% cases had a successful VBAC and 15% underwent a repeat emergency LSCS for failed trial of vaginal delivery. Cervical dilatation of more than 3 cm at the time of admission was a significant factor in favor of a successful VBAC. Birth weight of more than 3,000 g was associated with a lower success rate of VBAC. The incidence of scar dehiscence was 2% in the present study. There was no maternal or neonatal mortality.
CONCLUSION
Trial of VBAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas.
背景
剖宫产率呈上升趋势。越来越多的女性有剖宫产史。尝试经阴道分娩可使这些女性避免再次剖宫产的风险。
目的
本研究旨在评估在部分有一次下段剖宫产史的病例中，剖宫产术后阴道分娩（VBAC）的安全性和成功率。
材料与方法
在一家三级护理教学医院进行了为期两年的前瞻性观察研究。100名有一次下段剖宫产史的孕妇纳入本研究。
结果
在本研究中，85%的病例成功进行了VBAC，15%因阴道试产失败而接受了再次急诊下段剖宫产。入院时宫颈扩张超过3cm是VBAC成功的一个重要因素。出生体重超过3000g与VBAC成功率较低相关。本研究中瘢痕裂开的发生率为2%。无孕产妇或新生儿死亡。
结论
在剖宫产率不断上升的当今时代，尤其是在农村地区，对部分病例进行VBAC尝试具有重要意义。
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