一项关于既往剖宫产术后阴道分娩成功的各种预测因素的观察性研究。
An observational study of various predictors of success of vaginal delivery following a previous cesarean section.
作者信息
Gupta Smriti, Jeeyaselan Shanti, Guleria Raka, Gupta Anjali
机构信息
DNB Obstetrics and Gynecology, Dr. RML Hospital, New Delhi, India ; A 38/2, Kirti Palace, Jagriti Vihar, Meerut, UP India.
Obstetrics & Gynecology, Holy Family Hospital, New Delhi, India.
出版信息
J Obstet Gynaecol India. 2014 Aug;64(4):260-4. doi: 10.1007/s13224-014-0519-2. Epub 2014 Mar 19.
OBJECTIVES
To study the various predictors of success for vaginal birth after cesarean (VBAC) and to study the maternal and fetal outcomes in them and their comparison with control group.
METHODS
This prospective observational study included 100 women with previous cesarean section in the study group and 100 primigravidas in the control group. Various predictors for success of VBAC were analyzed and maternal and fetal outcomes were compared with the control group using student t test, Pearson χ (2) test, and Mann-Whitney U test.
RESULTS
Of 100 women with prior cesarean Sect. 65 had successful trial of labor, while 35 underwent a repeat cesarean section. Maternal complications in the previous CS group were 15 % as compared to only 2 % in the control group (p < 0.001).
CONCLUSION
Maternal pre-pregnancy BMI, non-recurring indications of previous cesarean section, good Bishop's score at the time of admission, spontaneous onset of labor, and neonatal birth weight were significantly related to high chances of success of vaginal birth after previous cesarean section. Maternal complications were more common in study group, but the fetal outcomes were similar.
目的
研究剖宫产术后阴道分娩（VBAC）成功的各种预测因素，并研究其母婴结局以及与对照组的比较。
方法
本前瞻性观察性研究包括研究组中100例有剖宫产史的女性和对照组中100例初产妇。分析VBAC成功的各种预测因素，并使用学生t检验、Pearson χ²检验和Mann-Whitney U检验将母婴结局与对照组进行比较。
结果
在100例有剖宫产史的女性中，65例试产成功，而35例行再次剖宫产。既往剖宫产组的母体并发症为15%，而对照组仅为2%（p<0.001）。
结论
孕前母体BMI、既往剖宫产的非复发性指征、入院时良好的 Bishop 评分、自然发动分娩和新生儿出生体重与既往剖宫产术后阴道分娩成功的高几率显著相关。母体并发症在研究组中更常见，但胎儿结局相似。
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