Reif P, Brezinka C, Fischer T, Husslein P, Lang U, Ramoni A, Zeisler H, Klaritsch P
Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz, Graz, Austria.
Universitätsklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin, Medizinische Universität Innsbruck, Innsbruck, Austria.
Geburtshilfe Frauenheilkd. 2016 Dec;76(12):1279-1286. doi: 10.1055/s-0042-118335.
The new expert recommendation from the Austrian Society of Obstetrics and Gynaecology (OEGGG) comprises an interpretation and summary of guidelines from the leading specialist organisations worldwide (RCOG, ACOG, SOGC, CNGOF, WHO, NIH, NICE, UpToDate). In essence it outlines alternatives to the direct pathway to elective repeat caesarean section (ERCS). In so doing it aligns with international trends, according to which a differentiated, individualised clinical approach is recommended that considers benefits and risks to both mother and child, provides detailed counselling and takes the patient's wishes into account. In view of good success rates (60-85 %) for vaginal birth after caesarean section (VBAC) the consideration of predictive factors during antenatal birth planning has become increasingly important. This publication provides a compact management recommendation for the majority of standard clinical situations. However it cannot and does not claim to cover all possible scenarios. The consideration of all relevant factors in each individual case, and thus the ultimate decision on mode of delivery, remains the discretion and responsibility of the treating obstetrician.
奥地利妇产科学会（OEGGG）的新专家建议包含了对全球主要专业组织（英国皇家妇产科医师学院、美国妇产科医师学会、加拿大妇产科医师学会、法国国家妇产科医师学会、世界卫生组织、美国国立卫生研究院、英国国家卫生与临床优化研究所、UpToDate）指南的解读与总结。本质上，它概述了选择性再次剖宫产（ERCS）直接路径的替代方案。这样做符合国际趋势，即建议采用差异化、个体化的临床方法，该方法要考虑对母婴的益处和风险，提供详细的咨询并考虑患者的意愿。鉴于剖宫产术后阴道分娩（VBAC）有良好的成功率（60 - 85%），在产前分娩计划中考虑预测因素变得越来越重要。本出版物为大多数标准临床情况提供了简洁的管理建议。然而，它无法也并不声称涵盖所有可能的情况。在每个具体病例中考虑所有相关因素，因此关于分娩方式的最终决定仍由主治产科医生自行判断并负责。
