剖宫产术后经阴道分娩：管理争议

Vaginal birth after cesarean section: management debate.

作者信息

Chattopadhyay K, Sengupta B S, Edress Y B, Lambourne A

机构信息

Maternity and Children Hospital, King Saud University, Riyadh, Saudi Arabia.

出版信息

Int J Gynaecol Obstet. 1988 Apr;26(2):189-96. doi: 10.1016/0020-7292(88)90261-5.

DOI:10.1016/0020-7292(88)90261-5

PMID:2898393

Abstract

Obstetric performance of 1847 women with previous cesarean section (CS) during the years 1983 and 1984 were studied. Vaginal birth after cesarean section (VBAC) was attempted in 94% of females with one previous CS, 4% in those with two previous CS, and one among the 70 patients with three or more previous CS. VBAC was achieved in 51% of those with one previous CS. It was successful in 60% of parturients with CS for non-recurrent causes, 36% of CS for cephalopelvic disproportion (CPD) and in 64% of those with a prior vaginal delivery. Uterine scar dehiscence was found in 0.9% of all patients with a previous CS. A failed attempt with Ventouse to achieve VBAC caused maximum maternal and perinatal morbidity.

摘要

对1983年和1984年间1847例有剖宫产史的女性的产科情况进行了研究。94%有一次剖宫产史的女性尝试了剖宫产术后阴道分娩（VBAC），有两次剖宫产史的女性中这一比例为4%，70例有三次或更多次剖宫产史的患者中有1例尝试了VBAC。有一次剖宫产史的患者中51%成功实现了VBAC。因非复发性原因行剖宫产的产妇中60%的VBAC成功，因头盆不称（CPD）行剖宫产的产妇中36%的VBAC成功，有既往阴道分娩史的产妇中64%的VBAC成功。既往有剖宫产史的所有患者中0.9%发生子宫瘢痕裂开。使用胎头吸引器尝试VBAC失败导致产妇和围产儿发病率最高。